Perspectives on building healthy communities

National Policy Implications Panel

 (l to r) Dr. Garth Graham, president, Aetna Foundation; Wendy Ellis, project director, Building Community Resilience Collaborative, GWU; Stuart M. Butler, The Brookings Institution

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After decades of working at the national level on health and mental policy in Washington, DC, I find myself looking for ways to get involved locally—the closer to home the better, and the more tangible the work, the more gratifying. There has never been a better time to act locally, not just because of the polarized national scene, but because opportunities abound to really make a difference at the local level.

With this budding interest local involvement taking shape, I was eager see what lessons I could learn from a May 9th event titled “New directions for communities: How they can boost neighborhood health,” sponsored by the venerable organization The Brookings Institution, best known for leadership at the national and global levels.

Brookings has developed a series titled “Building Healthy Neighborhoods” that is exploring “the crucial elements to building a culture of health, education, and economic mobility in low-income communities.” Since my neighborhood has people of all income levels and has undergone rapid gentrification especially in the last decade, its diversity is a source of its vitality but also presents challenges in creating community. A number of the reports in the series provide ideas and strategies for addressing problems at the neighborhood level.

What I didn’t expect to hear at the Brookings meeting was the degree of interest by several of the presenters in the role that “villages” could play in improving community health. Villages are springing up around the country to help people “age in place” by addressing the multiple needs of seniors. Village members are both lending and receiving help.

Members of Mt. Pleasant Village

Volunteers in the Mt. Pleasant Village meet to discuss the village’s participation in a study on social inclusion among its members. Pictured here (l to r) are Bonnie Cain, Kelly Callahan, Katie Tyler, Sharon Hart

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Two studies aim to bring funding and attention to neurofeedback in the treatment of PTSD

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“Almost half the nation’s children have experienced at least one or more types of serious childhood trauma, according to a new survey on adverse childhood experiences by the National Survey of Children’s Health (NSCH). This translates into an estimated 34,825,978 children nationwide, say the researchers who analyzed the survey data. Jane Ellen Stevens, ACEsTooHigh.com

Research from the CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study) shows that people who suffer early childhood neglect and abuse get sick more often throughout their lives and with more serious illnesses than the average population. They also become addicted at much higher rates and are far more likely to attempt and commit suicide. As a result of all of these factors, as a cohort, people who have experienced an overwhelming amount of abuse and neglect as children will die 20 years ahead of their peers.

According to the CDC, “Childhood experiences, both positive and negative, have a tremendous impact on future violence, victimization and perpetration, and lifelong health and opportunity. As such, early experiences are an important public health issue.” The CDC and Kaiser Permanente launched the first study on this topic from 1995 to 1997, as part of an effort to better understand how childhood abuse and neglect affect later-life health and well-being.

There are numerous treatments available to those who have suffered trauma. However, PTSD, and particularly developmental trauma often leads to chronic, treatment-resistant psychological and physical conditions that ruin lives and strain communities.

Abuse and neglect in childhood lead to disorganized brains that are typically overrun by the limbic eruptions of fear, shame and rage. Medications and talk therapy have not yielded much help. In fact across the board, mental health statistics are worse in the last 30 years — after the introduction of psychotropic medications, according to Tom Insel, director of the National Institute of Mental Health.

Neurofeedback offers a new approach to regulating the brain and, in turn, to quieting the minds of those so injured in early childhood.

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New Orleans Mayor Mitch Landrieu’s address on removal of four Confederate statues

This 22 minutes is definitely worth the time. New Orleans Mayor Mitch Landrieu eloquently describes why New Orleans removed the statues, which weren’t erected immediately after the Civil War to honor the fighters, but to remind all who passed by the statues about white supremacy.

Here’s the text from the YouTube page on which this video appears:

On Friday, May 19, 2017, Mayor Mitch Landrieu delivered an address about the City of New Orleans’ efforts to remove monuments that prominently celebrate the “Lost Cause of the Confederacy.” The statues were erected decades after the Civil War to celebrate the “Cult of the Lost Cause,” a movement recognized across the South as celebrating and promoting white supremacy.

There are four prominent monuments in question. The Battle of Liberty Place monument was erected by the Crescent City White League to remember the deadly insurrection led by white supremacists against the City’s racially integrated police department and government. The Jefferson Davis statue on Jefferson Davis Parkway, the P.G.T. Beauregard equestrian statue on Esplanade Avenue at the entrance to City Park, and the Robert E. Lee statue at Lee Circle.

Putting Alaska Native hopes, voices at center of state’s ACEs movement

Lisa Wade is the Health, Education, and Social Services Director, tribal court judge, and elected tribal council member for the Alaska Native Village of Chickaloon.

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Before the Alaska Resilience Initiative could push forward on any of its goals—to grow a sustainable statewide network; to educate all Alaskans on brain development, adverse childhood experiences, and resilience-building; and to support organizational, policy and practice change to address trauma—its leaders had to start by listening.

Specifically, they had to listen to Alaska Native people.

Alaska Native people comprise nearly one-fifth of the state’s population, but historically their voices have been largely excluded from decision-making about social services, education and behavioral health.

That’s why Laura Norton-Cruz, program director of the Alaska Resilience Initiative, partnered with First Alaskans Institute and the Chickaloon Village Traditional Council in a May 2016 gathering that put Native perspectives, customs, history and hopes at the center.

That gathering of about 30 people “was setting a tone for the whole state that the voices of Alaska Native people matter in this process,” Norton-Cruz said. The goal was to seek input that could guide the Alaska Resilience Initiative, shape the curriculum for ACE/resilience trainers and frame a more inclusive and equitable approach to the work.

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Battling meth: A rural Montana county starts drug court to reverse surge of kids in foster care

By Daniel Heimpel

When James Manley came to rural Lake County, Montana, as a district judge in 2013, he knew the meth problem was bad, but he didn’t know how much worse it would get.

Judge James Manley

Three-and-a-half years ago, Manley says the courthouse was processing roughly 220 felony cases a year. This year, he says the county will handle upwards of 500 drug-related felonies, and that at least 400 of those arrested will be parents.

“The destruction to families is incredible,” Manley said. “It breaks your heart to see families torn apart by addiction.”

Lake County, tucked in the northwest corner of the state, is at a breaking point. The jail regularly has inmates sleeping on the floor, the courts are clogged and kids are entering the foster care system at a stunning rate.

While the county is unique in that more than two-thirds of its 1,600 square miles of pristine forest, farms and pastureland sit on the Flathead Reservation of the Confederated Salish and Kootenai Tribes, its meth problem is part of much larger, and disturbing, trend.

In October 2016, the federal Administration for Children and Youth and Families (ACYF), which oversees foster care nationwide, pointed to substance abuse – particularly meth and opioids – as a driving factor in a steady three-year increase in foster care numbers. From 2013 to 2015, the last year of national data available, the number of children in foster care grew from 401,000 to almost 428,000.

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Providers hope trauma legislation will help native children in foster care

By Jeremy Loudenback

Recent federal legislation put forward by Sens. Dick Durbin (D-IL), Al Franken (D-MN) and Heidi Heitkamp (D-ND) proposes to address the issue of childhood trauma through the creation of a federal trauma task force.

The Trauma-Informed Care for Children and Families Act would gather federal officials and members of tribal agencies to create a set of best practices and training to help create a better way to identify and support children and families that have experienced trauma.

In North Dakota, the home state for co-sponsor Heitkamp, advocates are hoping that the bill can have an impact on addressing the needs of Native American children who disproportionately enter the state’s foster care system. According to one report, Native American youth deal with post-traumatic stress disorder at a rate of 22 percent, three times the national average and at the same level as Iraq and Afghanistan war veterans.

At PATH North Dakota, a non-profit child and family services agency, a trauma-informed approach means helping Native American children address historical trauma, as well as contemporary adverse experiences faced by children in foster care.

Jodi Duttenhefer and Heather Simonich, operations directors at PATH, recently talked with The Chronicle of Social Change about the new legislation, the importance of collecting data on the adverse childhood experiences of youth in its treatment foster care program and how the tribal community at Standing Rock is thinking about child trauma.

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Addiction doc says: It’s not the drugs. It’s the ACEs – adverse childhood experiences.

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He says: Addiction shouldn’t be called “addiction”. It should be called “ritualized compulsive comfort-seeking”.

He says: Ritualized compulsive comfort-seeking (what traditionalists call addiction) is a normal response to the adversity experienced in childhood, just like bleeding is a normal response to being stabbed.

He says: The solution to changing the illegal or unhealthy ritualized compulsive comfort-seeking behavior of opioid addiction is to address a person’s adverse childhood experiences (ACEs) individually and in group therapy; treat people with respect; provide medication assistance in the form of buprenorphine, an opioid used to treat opioid addiction; and help them find a ritualized compulsive comfort-seeking behavior that won’t kill them or put them in jail.

This “he” isn’t some hippy-dippy new age dreamer. He is Dr. Daniel Sumrok, director of the Center for Addiction Sciences at the University of Tennessee Health Science Center’s College of Medicine. The center is the first to receive the Center of Excellence designation from the Addiction Medicine Foundation, a national organization that accredits physician training in addiction medicine. Sumrok is also one of the first 106 physicians in the U.S. to become board-certified in addiction medicine by the American Board of Medical Specialties.

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