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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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.

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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Pediatrician develops whole-child assessment tool that includes ACEs questions

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Over the last dozen years or so, many pediatricians, astounded by the ramifications of the science of adverse childhood experiences (ACEs) on the children they care for, began integrating this science into their practices. The most common approach has been to ask parents about ACEs using a questionnaire, and to use this information to counsel parents and identify resources for the family. Different practices have been using different questionnaires: Some ask parents for their ACE scores along with their children’s; others also add a resilience survey.

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Greater Kansas City first responders, educators, health care workers, sports & faith community embrace learning about childhood trauma, practicing resilience

In a video on the Resilient KC website, police officer Mikki Cassidy notes that “my regular day is everybody else’s worst day.” Then she describes how mindfulness training has helped her find peace amid the clamor: “This moment, right here, I’m okay.”

Later in the clip, Sonia Warshawski, a Holocaust survivor, recalls being shoved onto a train to Treblinka and, later, losing her mother to the gas chamber. “One of my highest points is when I speak in schools, when students tell me, ‘You changed my life,’” she says.

And Josiah Hoskins, a youth raised in foster care, talks about the mantra that helped him survive: “Even if all you have is yourself, with a wall behind you and the world coming at you, you can make peace with yourself.”

The video concludes with four words—“Stories Matter. What’s yours?”—and an invitation for others to share experiences of adversity and healing.


Awareness on Both Sides of the State Line

The campaign is just one prong of Kansas City’s multi-sector effort to raise awareness about adverse childhood experiences (ACEs) and build resilience on both sides of the state line. Resilient KC — a partnership between the pre-existing Trauma Matters Kansas City (TMKC) network and the Greater Kansas City Chamber of Commerce — has worked to cultivate “ambassadors” who can bring the ACEs message to colleagues, clients and community members in business, the armed services, education, justice and health care.

ACEs are adverse childhood experiences that harm children’s developing brains so profoundly that the effects show up decades later; they cause much of the U.S. and the world’s chronic disease, most mental illness, and are at the root of most violence.

The CDC-Kaiser Adverse Childhood Experiences Study (ACE Study), a groundbreaking public health study, discovered that childhood trauma leads to the adult onset of chronic diseases, depression and other mental illness, violence and being a victim of violence.

The ACE Study looked at 10 types of childhood trauma: physical, emotional and sexual abuse; physical and emotional neglect; living with a family

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