Tucked into a curve of the Columbia River, which marks the watery border between Washington and Oregon, lies the small town of The Dalles. Its claims to fame include being a major Indian trading site for 10,000 years, a camping spot for Lewis and Clark in 1805, and the terminus of the Oregon Trail.
Now The Dalles is seeking a different kind of notoriety. This city of 13,000 is the first in the nation to seek certification from the Sanctuary Institute—a model of organizational change that challenges every part of the community to examine and remake itself through a trauma-informed lens.
Dalles (pronounced “dahl,” with a silent “s", is a French word for “slabs” of rock around and over which the Columbia once roared. The population of this rural community, 70 miles east of Portland, is mostly white, 30% Hispanic, and less than 10% other ethnicities. “It’s small enough that I’m able to call the chief of police and go out for coffee,” says Trudy Townsend, assistant to the superintendent of the North Wasco County School District 21.
The community is no different from others its size: If people don’t know you, they know someone who knows you. That intimacy provides a sense of belonging and connection that is hard to find in larger cities. But if you had told any leader—or citizen—in The Dalles in 2008 that deepening those connections and becoming a trauma-informed community was on the horizon, they would not have believed it.
That was the year when the U.S. Substance Abuse Mental Health Services Administration (SAMHSA) awarded the community a five-year, $2.7 million Safe Schools/Healthy Students grant. It specified that law enforcement, mental health, juvenile justice and education agencies work together to make schools safer and students healthier. “We added the Department of Human Services,” says Townsend, who was hired as project director.
“One of SAMHSA’s hopes for an outcome was that communities would build better relationships and systems.”
Many communities that received the grants hired school resource officers. The Dalles did something different. With the exception of the school district, which was the grantee, the partners on the core team did not receive any direct funding. They wanted to focus on sustainable change, so they combed the agencies’ data for specific problems and asked how each partner could help resolve them. For example, when data showed significant behavioral issues at the middle school among a group of students, the director of juvenile justice volunteered to greet those students at school every morning, and a targeted intervention for boys was put into place.
The core team opted to put resources into after-school programs, mental health and crisis intervention for students in the community’s three elementary, one middle and one high school. “We began to look at what was going on with families,” says Townsend. The services included therapists who could respond within 24 hours, five free counseling sessions for families and long-term intervention referrals. Over the five-year life of the grant, data showed a 13.2% decrease in student use of alcohol, 2.5% decrease in marijuana use, a 14% reduction in office referrals, and a decrease in physical fights. Students also reported feeling safer in school.
Behind the scenes, the grantees were building a foundation of trust that would take them on a journey they did not anticipate. The chief of The Dalles police department; the director of the Mid Columbia Center for Living, which provides mental health services; the superintendent of the North Wasco County School District; the regional director of the Oregon Department of Human Services; the director of Wasco County Youth Services and the administrator of the Wasco County Commission on Children and Families met once a month for five years.
“These weren’t midline managers,” says Townsend. This core team comprised people who could make decisions about the direction their organizations were heading. “It was really amazing to watch them form relationships and build trust.”
A turning point: understanding that trauma is a great equalizer
In 2011, year three of the grant, core team members had a pivotal conversation about the legacy of their project and how they could improve their community. The conversation took place during a two-day planning meeting in San Diego, sponsored by the Safe Schools/Healthy Students Initiative. Team members concluded that trauma was the great equalizer; it impacts individuals, organizations and whole communities. They decided to pursue the notion of trauma-informed care as a common concept.
“Then we went looking for a method to guide our madness,” says Townsend. They found it a month later, when Maggie Bennington Davis, a psychiatrist at Cascadia Behavioral Health Care in Portland, did a one-day training on trauma-informed care. Each of the grant partners sent staff. More than 250 people packed the room.
That was the core team’s first exposure to the research around adverse childhood experiences, including the Centers for Disease Control - Kaiser Permanente Adverse Childhood Experiences Study and the neurobiological effects of toxic stress on children’s brains. The ACE Study revealed a direct link between 10 types of childhood adversity and the adult onset of chronic disease (cancer, heart disease, diabetes, autoimmune diseases, etc.), mental illness, violence and being a victim of violence. It showed that childhood trauma was very common — two-thirds of adults have experienced at least one type. It showed that if people had experienced one, they usually experienced more. And the study showed the more types of trauma experienced, the higher the risk of chronic disease and mental illness. For example, an ACE score of 4 increased the risk of suicide by 1200 percent and alcoholism by 700 percent.
Davis also told them about the Sanctuary Institute, based in Yonkers, NY; the grantees were intrigued enough to investigate. Sanctuary, as it is commonly called, is a trauma-informed model for delivering care that takes into account the impact of exposure to violence, abuse, and other traumatic experiences on individuals, families, staff, and organizations. Hundreds of organizations have completed the three-year training required to earn certification from the Sanctuary Institute. Sanctuary has been integrated into residential treatment settings for children, domestic violence shelters, group homes, outpatient settings, substance abuse programs, parenting support programs and schools. But never—until now—into the workings of an entire town.
Representatives of the Sanctuary Institute visited The Dalles in May and June 2012. They met with the core team and, while the group was not yet fully convinced about committing to the training, its members agreed to organize a series of events: a community assessment, a two-day intensive training and a luncheon for community leaders that included the mayor, legislators and representatives from business, economic development and social services. The two-day training was open to each of the participating organizations. Members of the faith community, regional jail and the non-profit sector joined in.
The nickel drops on ACEs and Sanctuary
Then the core team, which still needed to feel certain that the model could work for The Dalles, sent representatives across the country for a five-day Sanctuary Institute training. It was there that the ACEs nickel dropped for the superintendent. “It was really a revelation,” says Townsend. “The superintendent began talking about ACEs with the community outreach team, a legislative advocacy group, meeting with the mayor, and with other school superintendents. We began to spread the message about ACEs.”
With the final year of the Safe Schools/Healthy Students Initiative funding approaching, the core team decided to move quickly, investing time, effort and significant funding into training and implementing the model within organizations.
“Our goal was to ‘re-script’ the future for our community,” says Townsend. “In addition to better outcomes for children, youth and families, we wanted to see a more positive outlook and more people taking pride in the community. Just as we were getting started, it seemed that disaster struck.” Within a span of two weeks, the community experienced two homicides and a police-involved shooting. The last incident happened during a technical assistance visit from a Sanctuary Institute representative.
“As a community, we were in shock,” recalls Townsend. “What we did as a group was a trauma-informed response. The shooting happened on Wednesday. By Saturday night, we had organized a candlelight vigil.” The local newspaper reported how the community had come together. “It was a story that marked a first step toward literally re-scripting the future,” she notes.
Throughout the winter, the Sanctuary trainers worked with team members from each organization. “We did a ton of work,” says Townsend. “It was a big push to the end.” In May 2013, Dr. Sandra Bloom, founder of Sanctuary, spent nearly a week in The Dalles. She trained 45 people during an intensive two-day workshop and did a half-day community-wide presentation for about 250 people.
“The community training was open to anyone,” says Townsend. “We did a huge marketing push. We hit every media outlet and invited everybody and his brother. We also hosted a luncheon for community leaders from government, faith community, business, non-profit, medical community and economic development. It was very successful.”
Funding from the Safe Schools/Healthy Students Initiative ended in June 2013, but The Dalles’ core team had made progress:
- As a group, they began to understand how past trauma had affected the community. It dated back at least to the 1950s, when The Dalles Dam was built and eventually submerged thundering Celilo Falls. The construction required a huge influx of workers; a company town was built, including its own schools and school district. “It created two sides of the track,” says Townsend. Ten years ago, after a vicious debate, the two high schools and districts merged. This came just after the closing of a large aluminum plant that had, for decades, provided steady high-wage employment for low-skilled workers. The Dalles took a huge economic hit; many families left or fell into poverty.
- Leaders acknowledged how deeply the community felt about current trauma—not only the recent violence, but the acrimony that occurred when a state law barring Native American mascots was passed. The Dalles-Wahtonka High School Eagle Indians logo, which shows both a sharp-beaked bird and a face in profile wearing a feathered headdress, will be replaced by a new symbol—one determined by the community.
- All major social service organizations have agreed to implement Sanctuary. This includes the school district, Mid Columbia Center for Living, the regional child welfare office of the Oregon Department of Human Services, Wasco County Youth Services Department, the Northern Oregon Youth Corrections Facility, as well as many smaller non-profit organizations such as the Haven From Domestic Violence. With a small amount of coordination, community partners come together each month in a learning circle where they take turns offering Sanctuary training to keep it fresh and introduce new partners to the model.
- Core group members have done many presentations about Sanctuary to local government, including the county board of commissioners and city government, intergovernmental organizations and statewide partners.
- The Dalles’ experience has inspired the Oregon Department of Health Services to explore the Sanctuary Model as a statewide approach to culture change within its child welfare division.
Significant changes have occurred in the schools. The first step the district took was to engage its leadership; instead of the occasional monthly meeting, the leadership team now meets twice a month at 6 a.m., a good hour to put trauma-informed practices to the test. The team includes directors, principals, vice principals and the superintendent. A smaller cabinet team meets every week and practices the Sanctuary commitments. The district also trained school board members in Sanctuary principles.
“We really concentrate on working through the issues using the Sanctuary problem solving method,” says Townsend. “If we have an issue that we know to be controversial and likely to have traumatic implications, we apply the processes. For example, we took a trauma-informed approach to changing the school mascot,” forming a committee dedicated to Sanctuary principles including democracy, open communication and nonviolence. That was reflected in how a local news organization covered the issue, quoting the school board chairman who used Sanctuary Model language.
The district is also doing more training—in September 2013, Maggie Bennington Davis trained all 300 school district staff in trauma-informed practices—and is changing its expulsion procedures. In the past, during an expulsion hearing for a child with explosive behavior issues, the expulsion panel may have “listened to a teacher’s horrified story and expelled the child,” says Townsend. Now the superintendent requires more digging into a student’s history, looking at other organizations the student is or is not engaged with and for triggers surrounding the event. The result may still be expulsion, but the approach has changed from “what’s wrong with this kid?” to “what’s happened to this kid?” And the expulsion, which used to merely kick a kid out of school, now comes with a plan that helps the child and the family.
When there are problems among staff members—from the school district and mental health, for example—and those staff members rant to their bosses, the leaders can call each other and find a way to solve the problem. “Both have the same concept of care in mind,” says Townsend. This has reduced chaos and increased equanimity in all of the organizations participating in Sanctuary.
SAMHSA grant ends; commitment to Sanctuary continues
Still, these are baby steps. There are pockets of early adopters in The Dalles and people who don’t buy into the trauma-informed concept at all. And because the SAMHSA grant ended, so did some of the therapeutic resources provided to students. Families no longer have access to free counseling, though the school still provides a referral service. (View the Dalles Chronicle article here.)
Because of the community’s commitment to Sanctuary, the school district found a way to maintain a small level of coordination while the core team looked for additional funding. The funding gap lasted only six months. At the beginning of 2014, the Oregon Health Authority provided an 18-month grant to the Mid Columbia Center for Living. The funding has been used to continue Sanctuary training and expand the effort to cover neighboring communities. “It’s a band-aid to keep us going,” says Townsend. “I need to keep looking for funding.”
During the first six months of the grant, 375 people were trained in the psychobiology of trauma, mental health first aid, and collaborative problem-solfing. In August, 55 people from nine new organizations were trained in Sanctuary.
“There is a ton of stuff going on all the time,” says Townsend. “There have been book clubs and study groups. A local physician attended one of our meetings and was inspired to write a beautiful article in her church newsletter about trauma-informed care and our local efforts.”
In addition, in March 2014, the Mid Columbia Center for Living joined the National Council on Behavioral Health’s 2014-2015 Trauma-Informed Learning Community. “Actually, we joined as a collaborative,” explains Townsend, “but it is the Center that is most engaged. We joined because they have different screening tools that we’re interested in learning about. And it fits, because they use a lot of Sandra Bloom’s work.”
“We have come a long way in a very short time,” says Townsend. “And we have a long way to go. We’re committed to implementing this community wide. We’re re-scripting the way our community reacts to trauma.”
This is one of several articles about how different towns, cities, states and provinces are beginning to embrace an ACEs movement and become engaged in preventing/treating ACEs and promoting resilience. They were done as part of a Community Resilience Cookbook, produced by the Health Federation of Philadelphia with support from the Robert Wood Johnson Foundation.