High cost of childhood trauma in Alaska is documented, especially in Alaskan Native people

Screen Shot 2015-04-10 at 9.28.16 AMAccording to two sobering reports that have been released on the impact of adverse childhood experiences (ACEs) on Alaskans and on the state’s Native people, the prevalence of all of the eight ACEs measured was higher for Native Alaskans than non-Natives. Almost half of all Native Alaskans grew up with someone who had a substance abuse problem. The rate of sexual abuse is 32% among Alaska Native women, highest of any state’s ACE results. And the prevalence of four or more ACEs in the Native Alaskan community is nearly double that of non-Alaska Natives.

The reports give specificity to the health, economic, and social challenges that are widely recognized both in the general population and among Native Americans in the state. The data was derived from the optional ACEs module in the Behavioral Risk Factor Surveillance System (BRFSS) survey conducted for the first time in Alaska in 2013.

Because of the strong demand for the information, the Alaska Tribal Health Consortium released an “Executive Summary” of the ACEs data on Alaska Native (AN) people in advance of the broader report, “Adverse Childhood Experiences: Overcoming ACEs in Alaska,” by the Advisory Board on Alcoholism and Drug Abuse and the Alaska Mental Health Board (AMHB /ABADA ).

The report on Alaska Native people compared ACEs with the non-Native Alaskan population while the comprehensive report compared all Alaskans with a proxy for a national sample (data from the five-state CDC report.) The prevalence of all of the eight ACEs measured was higher for Native Alaskans than non-Natives and significantly higher for five of the eight ACEs. Almost half of all ANs live with someone with a substance abuse problem, compared to approximately 30% of non-Natives. Comparing state and national data, Alaska’s measured rates were found to be higher on all 8 ACEs than in those five-state totals.

There was a significant difference between the prevalence of 4 or more ACEs in Alaska Native people compared to non-Alaska Natives—27.9% in contrast to 15.5%. The survey of the entire Alaska population compared to a proxy for a national population revealed that 17.3% of Alaskans have an ACE score of four or more compared to 15.2% in the national sample. If the number of Alaskans with an ACE score of 4 were reduced to the level reflected by the national survey—meaning 11,500 fewer Alaskans with a score of four—there would a highly positive impact on “many health, economic, and social outcomes,” according to the report.

The Alaska Native report found a similar prevalence of ACEs among AN females and males (i.e., divorce, verbal abuse, witness to domestic violence) except for sexual abuse which is estimated to be 32% for females compared to 11.7% for males. The extremely high level of sexual abuse throughout the state is a matter of grave and long-term concern for public health officials and family advocates throughout the state. Dr. Linda Chamberlain, director of Alaska Family Violence Prevention Project, visits with women throughout rural Alaska who report widespread sexual abuse—an experience she says is the norm rather than the exception.

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Patrick Sidmore

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“The best way to treat mental illness is to prevent it,” says Patrick Kennedy at launch of the Kennedy Forum Illinois

Leventhal+Kennedy+Cochran+ChoucairA full day of events in Chicago last month formally launched the Kennedy Forum Illinois, bringing together elected officials, civic and philanthropic leaders, educators, mental health experts, researchers and advocates—all focused on how to improve mental health statewide. A major concern was reducing childhood adversity and trauma, an especially daunting challenge in Chicago, where high levels of gun violence persist.

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CA Senate unanimously approves ACEs reduction resolution

California Dome & Senate SealOn August 18, the California Senate unanimously approved Concurrent Resolution (ACR) No. 155 to encourage statewide policies to reduce children’s exposure to adverse childhood experiences. As reported on ACEs Too High, the resolution is modeled after a Wisconsin resolution that encourages state policy decision-making to consider the impact of early childhood adversity on the long-term health and well being of its citizens. Since the resolution does not require California Gov. Jerry Brown’s signature, the Senate’s approval is the final step in the process.

The resolution echoes the language of a Wisconsin bill passed earlier this year—the state’s policies should “consider the principles of brain development, the intimate connection between mental and physical health, the concepts of toxic stress, adverse childhood experiences, buffering relationships, and the roles of early intervention and investment in children…”

New programs or mandates are not included in the resolutions, but both provide an important framework for state level decision-making that is informed by the findings of the CDC’s Adverse Childhood Experiences (ACE) Study. The two state resolutions are natural extensions of already robust ACEs-related and trauma-informed programs and policies in those states.

The principal sponsor of the California resolution was Assembly Member Raul Bocanegra (D-Pacoima) who spoke on behalf of the resolution on the Assembly floor and was joined by Rob Bonta (D-Oakland) and Reginald B. Jones-Sawyer, Sr. (D-Los Angeles). Bonta said that “sadly and tragically” almost every youth in the City of Oakland has been touched by violence and that life expectancy is negatively impacted by conditions in vulnerable communities. Jones-Sawyer said that conditions that result in urban PTSD are “unnoticed and unaddressed.”  To see these short speeches, click here http://calchannel.granicus.com…d=7&clip_id=2332 and scroll down to ACR 155. The video also shows the adding of 68 members as coauthors.

During the weeks after the Assembly passage and before the Senate action, advocates led by the Center for Youth Wellness built support for the resolution.  Senator Holly Mitchell (D-Los Angeles), chair of the California Legislative Black Caucus, was the floor

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Patrick Kennedy builds connections among diverse sectors to change healthcare

(l to r) Patrick Kennedy, Bill Emmet, Kennedy Forum executive director, and Mike Thompson

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Former U.S. Congressman Patrick Kennedy is building a “Community of Mental Health,” by making connections that are needed for mental health to be fully integrated into our understanding of overall health. To achieve this goal, the son of U.S. Senator Edward M. Kennedy has created the Kennedy Forum—so named to evoke the memory of President John F. Kennedy and employ the family name to inspire, motivate, and unite advocates and policymakers around a shared vision of what healthcare should be. The Kennedy Forum is focused on the development, implementation, and dissemination of mental health and addiction policy and standards—with the first order of business being the implementation of the new mental health and addiction parity law.

The Kennedy Forum is providing this leadership by convening people with diverse interests and perspectives in a variety of formats including one-on-one meetings, national summits, locally focused seminars and forums being held venues as diverse as Chicago and Cape Cod. The goal of the Forum is to help shape the service delivery and payment system of the future—one that encourages prevention, early intervention, and coordinated care for all who need it.

Patrick Kennedy (center) addresses gathering at the Kennedy compound in Hyannis Port, MA

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The premier meeting of the Kennedy Forum was held at the Kennedy Library in Boston in the fall of 2013 (the second such meeting will be held in June 2015). Earlier this summer, a series of small gatherings took place at the Kennedy compound in Hyannis Port, on Cape Cod in Massachusetts. A meeting is scheduled for November 13 in Chicago to address local issues. Part of that meeting will address prevention and early intervention in mental health, including the traumatic impact of community violence on the city’s children.

Arthur Evans

Arthur Evans at Philadelphia “I Will Listen” event

The gatherings at the the family home on Cape Cod brought together leaders from a variety of fields to share experiences and expertise and learn from each other, often for the first time. Here are several examples of participants who illustrate different perspectives on improving health in the broadest sense of the word:

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Massachusetts “Safe and Supportive Schools” provisions signed into law, boosts trauma-informed school movement

Massachusetts Gov. Deval Patrick

Massachusetts Gov. Deval Patrick

Massachusetts Governor Deval Patrick today signed into law provisions to create conditions for “safe and supportive schools” intended to improve education outcomes for children statewide, and giving momentum to the state’s trauma-informed schools movement. They were included in The Reduction of Gun Violence bill (No. 4376). This groundbreaking advance was achieved when advocates seized the opportunity to add behavioral health in the schools to the options under consideration as state officials searched for ways to strengthen one of the nation’s more restrictive gun laws in the aftermath of the tragic shooting of schoolchildren in Newtown, CT.

House Speaker Robert DeLeo saw the connection between reducing gun violence and school achievement and was instrumental in the bill’s passage. When the original sponsor of a Safe and Support Schools Act, Katherine Clark, left the state legislature for the U.S. House of Representatives, some advocates were concerned the void would not be filled. Their fears were assuaged when Rep. Ruth Balser of Newton and Sen. Sal DiDomenico of Boston became lead sponsors.

The schools act supporters were jubilant that the legislation they labored on for years was incorporated in the gun violence bill now signed into law, and expressed deep relief and excitement about the achievement. They also said the hard work of statewide implementation now begins.

The law requires the state education department to develop a framework for safe and supportive schools, first developed by a task force established by the legislature in 2008, that provides a foundation to help schools create a learning environment in which all students can flourish. The framework is based on a public health approach that includes fostering the emotional wellbeing of all students, preventive services and supports, and intensive services for those with significant needs.

Within the framework, schools are encouraged, but not mandated, to develop action plans that will be incorporated into the already required School Improvement Plans. The law also provides a self-assessment tool to help in the creation of the plans.

Under the leadership of the Trauma and Learning Policy Initiative (TLPI), a coalition of the Massachusetts Advocates for Children and Harvard Law School, the “Safe and Supportive Schools Coalition” was formed to move the legislation

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California Assembly Health Committee OKs ACEs resolution 16-0

ImageThe California Assembly Health Committee today approved, by a vote of 16-0, a resolution to encourage statewide policies to reduce children’s exposure to adverse childhood experiences. California took a page from Wisconsin’s playbook with the introduction of legislation (California Assembly Concurrent Resolution (ACR) No. 155) on May 28. It drew upon ideas from Wisconsin’s legislation (Senate Joint Resolution 59), approved by the legislature this early this year. Both the Wisconsin resolution and the California proposal encourage state policy decision-making to consider the impact of early childhood adversity on the long-term health and well being of its citizens.

Before the vote was taken on June 17, the lead sponsor of the California bill, Assemblymember Raul

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Vermont legislator hopes to transform his “Adverse Legislative Experience (ALE)”

ImageThe principal sponsor of the Vermont ACEs bill, Dr. George Till, has an ALE (not a typo) score of at least one. He describes losing six of seven sections of the ACEs legislation as an “Adverse Legislative Experience (ALE)”. But if re-elected this November, he plans to “push again next session” for provisions to embed the ACEs research findings into medical practice. While “extremely disappointed” with the outcome of the conference committee dropping most of his bill’s provisions, his resiliency is evident as he looks ahead to the next opportunity to improve health outcomes.

On May 10, the last day of the Vermont legislature, a broad healthcare bill (H. 596) passed that included the one remaining ACEs provision. This section mandates a review by Jan. 15, 2015 of “evidence-based materials on the relationship between adverse childhood experiences (ACEs) and population health and recommend to the General Assembly whether, how, and at what expense ACE-informed medical practice should be integrated into

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