Category Archives: Uncategorized

Patient’s murder leads to soul searching, shift to ACEs science in UCSF medical clinic

October 27, 2017 By in ACE Study, Adverse childhood experiences, Child trauma, Trauma, Uncategorized Tags: , , 3 Comments
Patient’s murder leads to soul searching, shift to ACEs science in UCSF medical clinic

It was the murder of a beloved patient that led to a seismic shift in the Women’s HIV Program at the University of California, San Francisco: a move toward a model of trauma-informed care. “She was such a soft and gentle person,” said Dr. Edward Machtinger, the medical director of the program, who recalled how utterly devastated he and the entire staff were by her untimely death.

“This murder woke us up,” he said. ”It just made us take a deeper look at what was actually happening in the lives of our patients.” The Women’s HIVprogram, explained Machtinger, was well regarded as a model of care for treating HIV patients – reducing the viral load of HIV in the majority of its patients to undetectable levels.

But the staff was clearly missing something. A closer look at the lives of their patients revealed that 40 percent were using hard drugs – including heroin, methamphetamine and crack cocaine, according to Machtinger. Half of them suffered clinical depression, the majority had isolated themselves due to deep shame associated with having HIV, and many experienced violence.

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

May 29, 2017 By in Adverse childhood experiences, Community prevention programs, Uncategorized 1 Comment

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.

Pueblo, CO, clinic rewrites the book on primary medical care by asking patients about their childhood adversity

December 20, 2016 By in ACE Study, Adverse childhood experiences, Child trauma, Chronic disease, Community prevention programs, Uncategorized 12 Comments

mombaby

In October 2015 in Pueblo, CO, the staff members of a primary care medical clinic – Southern Colorado Family Medicine at the St. Mary-Corwin Medical Center – start asking parents of newborn babies to kids five years old about the parents’ adverse childhood experiences and the resilience factors in their lives. They ask the same questions of pregnant women and their partners in the hospital’s high-risk obstetrics clinic.

The results are so positive after the first year that the clinic starts asking parents of kids up to 18 years old. The plans are to do the same in the hospital’s emergency room.

Why? They think it gives kids a leg up on a healthier start in life. They think it helps adults understand and manage their own health better. They think it helps physicians better understand and help their patients. Oh yeah – and it looks like it’s going to save money. Probably a lot of money.

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This EMT integrates ACEs, offers emotional first aid

October 4, 2016 By in ACE Study, Adverse childhood experiences, Child trauma, Solutions, Uncategorized 5 Comments
chiavetta

Peter Chiavetta and the handouts he gives patients

One day, when Peter Chiavetta was just out of college, he was driving down a road in Eden, NY. Before he could even give the slightest conscious thought to his actions, he swerved off the road onto the shoulder. The car that was heading straight at Chiavetta slammed into the vehicle behind him.

“I thought I was a good prepared citizen,” recalls Chiavetta. “I had road flares and a two-pound fire extinguisher in the trunk of my car. I’m standing in the middle of the road with my little fire extinguisher, while on the ground the two passengers in the car behind me had been ejected and were lying motionless. Out of nowhere a man appeared with a first-aid kit and tried to help one of the victims. The driver — covered with blood and his knees are chopped down to bone — was calling out to me for help. I had no idea how to help him.”

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How to bring restorative justice to your school

February 22, 2016 By in Uncategorized 1 Comment

Levine-336x336By David Levine, JJIE.org

Hey, you! Yes, YOU can make it happen! Anyone can. Whether you are a principal, a student, counselor or teacher, you can be the one to speak up for restorative justice. “Be the change you wish to see in the world” (Mahatma Gandhi).
Though I currently work full time as a restorative justice facilitator, it wasn’t always this way. At my last school it was a student, a junior, who decided our school needed this approach. He found backing from our principal, and he found a mentor in me, his advisor/teacher.

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Katie A. foster care case, part 3: Los Angeles — making progress, but much work left in mental health services

November 21, 2014 By in Uncategorized Leave a comment

AastridBy Jeremy Loudenback

The Katie A. v. Bonta lawsuits leveled California and Los Angeles County with the charge that every county in the state provide adequate mental health services for some of its most vulnerable children.

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Katie A. foster care case, part 2: Sun sets, perhaps prematurely, on CA settlement

November 21, 2014 By in Uncategorized 1 Comment
National Center for Youth Law Executive Director John O’Toole.

National Center for Youth Law Executive Director John O’Toole.

By John Kelly

In Katie A. v Bonta, a class-action lawsuit over mental health services for children involved in California’s child welfare system, Los Angeles County settled with plaintiffs in 2003; the state settled on behalf of the other 57 counties in 2011.

Like most lawsuits and the settlements that stem from them, Katie A. involves lots of technical requirements. Counties must demonstrate that they assess and treat mental health using a core practice model that involves specified coordination and service delivery strategies.

But what it comes down to is this: Prior to the settlements, child welfare agencies in California were failing on both ends of the mental health spectrum.

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CA Senate unanimously approves ACEs reduction resolution

August 21, 2014 By in Uncategorized 6 Comments

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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Vermont first state to propose bill to screen for ACEs in health care

March 17, 2014 By in Uncategorized Tags: , , , , , 12 Comments
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Dr. George Till, Vermont state legislator and physician

When Vermont State Legislator and physician Dr. George Till heard Dr. Vincent Felitti present the findings of the CDC’s Adverse Childhood Experiences Study at a conference in Vermont last October, he had an epiphany that resulted in a seismic shift in how he saw the world. The result: H. 762, The Adverse Childhood Experience Questionnaire, the first bill in any state in the nation that calls for integrating screening for adverse childhood experiences in health services, and for integrating the science of adverse childhood experiences into medical and health school curricula and continuing education.

That Vermont would be the first in the nation to address adverse childhood experiences so specifically in health care at a legislative level isn’t unusual. More than most states, Vermont is a “laboratory of change” for health care. It has embraced universal health care coverage for all Vermonters, and it passed the nation’s first comprehensive mental health and substance abuse parity law. (Washington State passed a law in 2011 to identify and promote innovate strategies, and develop a public-private partnership to support effective strategies, but it was not funded as anticipated. The Washington State ACEs Public-Private Initiative is currently evaluating five communities’ ACE activities.)

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Arresting our way out of drug crisis is yesterday’s theory, says VT Gov. Shumlin; urges public health approach

January 30, 2014 By in Adverse childhood experiences, Community prevention programs, Solutions, Uncategorized Tags: , , , , 5 Comments

AshumlinState of the state addresses—like the State of the Union—tend to cover a wide range of topics from the economy to health care to education.  Vermont Governor Peter Shumlin broke the mold when he devoted his entire 2014 State of the State address to the state’s drug addiction crisis.  The rising tide of drug addiction and drug-related crime spreading across Vermont is “more complicated, controversial, and difficult to talk about” than any other crisis the state confronts, he said.

“We have lost the war on drugs,” he said. ” The notion that we can arrest our way out of this problem is yesterday’s theory.”  Even though Vermont is the second smallest state in the union (pop. 626,600), more than $2 million of heroin and other opiates are being trafficked into the state every week. Shumlin expressed alarm over the increase in the deaths from heroin overdose that doubled in 2013 from the year before and the 770 percent increase in treatment for opiates.

Shumlin told emotional stories of young Vermonters becoming addicted to prescription opiates and heroin — one recovered, one died from an overdose. While stories of young and promising individuals dying from heroin overdoses may grab headlines, data from the Centers for Disease Control and Prevention (CDC) show that deaths from prescription opioid pain relievers — such as codeine, methadone, and oxycodone — between 1999-2008 now exceed deaths involving heroin and cocaine combined.

CDC reports that in 2008, 36,450 deaths were attributed to drug overdoses in the U.S.  Opioid pain relievers were involved in 14,800 deaths (73.8%) of the 20,044 prescription overdose deaths.  The drug overdose death rate of 11.9 per 100,000 (Vermont’s rate was 10.9 per 100,000) was roughly three times the rate in 1991. Prescription drugs accounted for most the increase.  An April 12, 2012 statement from the Office of National Drug Control Policy reported that death from unintentional drug overdoses is greater than car accidents, the leading cause of injury in the U.S.

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