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PACEs in Medical Schools

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One state. One year. (Partial) Cost of ACEs = $5.2 billion.

Jane Stevens ·
In looking at the impact of childhood trauma, you can’t get much clearer than this: In 2017, ACEs among Tennessee adults led to an estimated $5.2 billion in direct medical costs and lost productivity from employees missing work. That’s just one year, according to the new report, “ The Economic Cost of ACEs in Tennessee ," released on Feb. 1, 2019 by The Sycamore Institute in Nashville, Tenn. And to provide some perspective, $5.2 billion is one-seventh of the state’s annual budget . This $5.2...
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Op-Ed: I'm a doctor fighting COVID-19. Outside of the hospital, I've never felt more alone [latimes.com]

By Samuel Yamshon, Los Angeles Times, May 15, 2020 As I make my way into my building’s elevator after a long hospital shift, a neighbor throws his arm out to stop me. “Sorry,” he says, “only one person per elevator.” Seeing my confusion, our doorman kindly but firmly corrects him. “Two per elevator is fine.” I take a step toward the open doors, but the passenger again holds up his palm. “Please,” he pleads, his eyes glancing frantically at my scrubs. “Please, just take a different one.”...
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Overview of the Community Resiliency Model, used worldwide to help trauma survivors re-regulate their central nervous system, offered in two, free 90-minute webinars.

Carey Sipp ·
Elaine Miller Karas , key creator of the Community Resiliency Model (CRM), will be joined by CRM trainers from Wilmington, NC, Allison Wine , behavioral specialist, and Kelly Purcell , instructional coach and multi-tiered support specialist for this free, two-part training. Register now for two, FREE 90-minute sessions May 7 from 11 a.m. - 12:30 p.m. EST and May 14 from 11 a.m. - 12:30 p.m. EST (The complete overview requires attendance at both sessions. Registration link below registers you...
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Preventable trauma in childhood costs north America and Europe US$ 1.3 trillion a year [WHO]

Karen Clemmer ·
By World Health Organization (photo by WHO/Malin Bring) The findings of a new study on the life-course health consequences and associated annual costs of adverse childhood experiences (ACEs) show that preventable trauma in childhood costs north America and the European Region US$ 1.3 trillion a year. The article, published in the Lancet and co-authored by Dinesh Sethi and Jonathon Passmore, Programme Manager, Violence and Injury Prevention, WHO/Europe, looks at the legacy of ACEs and their...
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Sheltering in Place: ACEs-Informed Tips for Self-Care During a Pandemic

Jim Hickman ·
Millions of lives have been affected in unprecedented ways by the Coronavirus (COVID-19). We are all grappling with uncertainty—our daily routines interrupted, not knowing what is to come. For those of us who have Adverse Childhood Experiences (ACEs), these times can be particularly distressing. At the Center for Youth Wellness (CYW), we know that childhood trauma can have a significant impact on an individual’s health and well-being – both physiologically and psychologically. Since the...
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Study: Stress Disorders Linked to Greater Infection Risk [mercurynews.com]

By Lisa Rapaport, Reuters, October 31, 2019 People who have stress disorders like PTSD may be more vulnerable to potentially life-threatening infections, especially if they are diagnosed at younger ages or dealing with other psychiatric issues, a recent study suggests. Researchers examined data on 144,919 people diagnosed with post-traumatic stress disorder (PTSD), adjustment disorders common after a major life change like a death or move, and other stress-related conditions. They also...
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The Center for Youth Wellness Launches Childhood Adversity Screening Program with Leading North Carolina Health Systems [PR Newswire]

Jim Hickman ·
Charlotte pilot program with Atrium Health and Novant Health supports state's goal to address social, economic and environmental health to improve child and family health outcomes The Center for Youth Wellness (CYW) announced it is partnering with two leading U.S. health systems in the Southeast to launch a screening program on childhood adversity. CYW's National Pediatric Practice Community (NPPC) has done on-site training at the headquarters of Atrium Health and Novant Health in Charlotte,...
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The Impact of Childhood Adversity on Health and COVID-19 [acpm.org]

By Kevin Sherin, American College of Preventive Medicine, May 7, 2020 There is a growing dialog about COVID-19 and its impacts on childhood adversity (ACEs), chronic stress, and mental health across the lifespan. The fear and social isolation associated with COVID-19 commonly exacerbates existing chronic stresses. Reports are surfacing of increased mental health problems, anxiety, partner violence, depression, suicidality, child abuse, opioid use disorder, other substance abuse, drug...
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The Link Between Childhood Trauma and Sexual Abuse in Adulthood

ana joanes ·
Please check out our latest Healing Our Ghosts' podcast with ECHO's executive director and #metoo Harvey Weinstein's silence breaker Louise Godbold. Healing Our Ghosts shines light into the suffering we keep hidden. We are not alone in our struggles and when we share our pain, we lift the shame secrecy that keeps us alone and disconnected from each other and prevents us from healing. With humor and compassion, Ana Joanes interviews a wide variety of guests about their messy lives, how they...
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The mother of invention (The Harvard Gazette)

Karen Clemmer ·
By M. R. F. Buckley, May 15, 2020, The Harvard Gazette. COVID-19 pandemic spurs creation of new, remote teaching methods at HMS When the COVID-19 pandemic prompted Harvard Medical School (HMS) to move learning online in March, faculty moved swiftly, developing new curriculum approaches, sometimes within hours, allowing educators to continue to teach classes and ensure that students are achieving learning objectives remotely. But, among Harvard Schools, they had some unique challenges. Part...
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The Relentless School Nurse: ACEs Impact Nurses More Than We Realized!

Robin M Cogan ·
I ran across this message on www.acesconnection.com and not only did it catch my attention, but it also made me want to dig deeper. Could it be true that nurses have a higher ACEs score than other healthcare professionals? It seemed true in this small survey, but was this a representation of a trend? If it was, the implications in nursing practice could be tremendous and concerning. What I found was that there is a grand canyon gap in research. The minimal studies that do exist confirm that...
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The Relentless School Nurse: When the Health Office Pass Includes Emotions

Robin M Cogan ·
The collaboration between school counselors and school nurses creates safe spaces for students at school. Building a coalition between school counselors and school nurses creates a safety net for our most complex and challenging students while benefiting the whole school community. Promoting connections through intentional relationship building, and ensuring a school environment that is physically, emotionally and psychologically safe changes the culture and climate. Read about an amazing...
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TIC: News and Notes for the Week of October 21, 2019 [dhs.wisconsin.gov]

Scott A Webb ·
ACEs, Adversity's Impact There is only one boat: The myth of normalcy by Dr. Gabor Mate Understanding historical trauma to strengthen community Childhood trauma linked to early, premarital childbirth and poor health for women Early life racial discrimination linked to depression, accelerated aging When mothers are killed by their partners, children often become 'forgotten' victims. It's time they were given a voice Children's language skills may be harmed by social hardship Does racism...
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Tools and how to use them is focus of second webinar on Community Resiliency Model, May 14, 2020

Carey Sipp ·
The second of two free Community Resiliency (CRM) webinars with Elaine Miller-Karas , key creator of the CRM, will be held Thursday, May 14, from 11 a.m. - 12:30 p.m. ET, (10 a.m. CT; 9 a.m. MT, and 8 a.m. PT) and will include the practical application of tools of the model. CRM is an ACEs science-based biological model for helping individuals become emotionally regulated during natural disasters and other dysregulating times. Miller-Karas will be joined by CRM trainers from Wilmington, NC:...
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Toxic Stress: Issue Brief on Family Separation and Child Detention [immigrationinitiative.harvard.edu]

By Jack P. Shonkoff, Immigration Initiative at Harvard, October 2019 Background The separation of children from their parents and their prolonged detention for an indefinite period of time raise profound concerns that transcend partisan politics and demand immediate resolution. Forcibly separating children from their parents is like setting a house on fire. Preventing rapid reunification is like blocking the first responders from doing their job. And subjecting children to prolonged...
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Trauma-Informed Care May Ease Patient Fear, Clinician Burnout [jamanetwork.com]

By Bridget M. Kuehn, JAMA Network, January 29, 2020 For many sexual assault survivors whom Anita Ravi, MD, MPH, sees as a New York City–based family physician, the prospect of even basic medical care can be frightening. Some have put off Papanicolaou tests and mammograms for years or even decades. To help them, Ravi has adopted a trauma-informed approach that works to restore patients’ trust and give them a greater sense of control over their visit. This may include asking permission before...
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Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic [jamanetwork.com]

By Tait Shanafelt, Jonathan Ripp, Mickey Trockel, JAMA, April 7, 2020 The coronavirus disease 2019 (COVID-19) pandemic has become one of the central health crises of a generation. The pandemic has affected people of all nations, continents, races, and socioeconomic groups. The responses required, such as quarantining of entire communities, closing of schools, social isolation, and shelter-in-place orders, have abruptly changed daily life. Health care professionals of all types are caring for...
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University of Florida Graduate Public Health Course: Trauma-Informed Approaches for Individuals, Communities, and Public Health: Student Project Summaries

Lindsey King ·
The University of Florida College of Public Health and Health Professions partnered with Peace4Tarpon under the Robert Wood Johnson Mobilizing Action for Resilient Communities (MARC) grant. Together they created 2 online graduate courses that focus on addressing ACEs and creating trauma-informed and resilience-based programs from a public health approach. Peace4Gainesville and Peace4 TheBigBend have also contributed to these courses. This post is intended to showcase some of the work of the...
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Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention [cdc.gov]

By Melissa T. Merrick, Derek C. Ford, Katie A. Ports, et al., Centers for Disease Control and Prevention, November 5, 2019 Summary What is already known about this topic? Adverse childhood experiences are common and are associated with many poor health and life outcomes in adulthood. What is added by this report? Nearly 16% of adults in the study population reported four or more types of adverse childhood experiences, which were significantly associated with poorer health outcomes, health...
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Webinar: Cultivating Our Best Selves in Response to COVID-19 | Tuesday, March 17 at Noon PDT

Elaine Miller Karas ·
How to use the skills of the Community Resiliency Model (CRM) for self and others to be the calm in the storm as we face the unknown. Free Webinar Tuesday, March 17 at Noon PDT Speakers: Elaine Miller-Karas, LCSW Linda Grabbe, PhD, FNP-BC, PMHNP-BC Zoom Webinar Registration Link: https://zoom.us/j/715837300 Additional ways to join are listed at the bottom of this post. About the webinar leaders: Elaine Miller-Karas is the Executive Director and co-founder of the Trauma Resource Institute and...
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WEBINAR - NPPC's Pilot Site Case Studies: Lessons Learned from ACEs Screening Implementation

Molly Peterson ·
The Center for Youth Wellness' National Pediatric Practice Community on ACES (NPPC) is a co-designed community committed to collaborative learning. To promote this learning, we have been working with six pilot sites over the last year, representing practices of various sizes and service delivery settings, to implement ACEs screening and intervention. On Monday, December 2nd at 1pm PT , we will be holding a webinar to discuss the findings of these pilot site case studies. Please register...
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Webinar Oct. 17 — Integrating ACEs science in pediatrics: Early adopters share lessons from the field

Laurie Udesky ·
An ACEs Connection webinar co-sponsored with 4 CA In 2017, California became the first state in the country to pass a law supporting universal screening for adverse childhood experiences (ACEs) in the 5.3 million children in the state’s Medicaid program. As clinicians around California await the state’s announcement of what this new policy will entail, many are wondering what it takes to integrate ACEs science in a pediatric practice. Meet Drs. Deirdre Bernard-Pearl, R.J. Gillespie and...
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When Hidden Grief Gets Triggered During COVID-19 Confinement

Tian Dayton ·
first published by The Meadows 4/15/20 Our sense of loss during the current COVID-19 crisis can trigger hidden emotions from when we experienced a sense of loss before. Whatever early losses you have had in your life — whether they be your own divorce, your parents, or both, or the abandonment of one parent, a childhood or parental illness or death, financial upheaval, constant moving around, or growing up with parental addiction or adverse childhood experiences (ACEs) — they are likely to...
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Women Surgical Residents Suffer More Mistreatment Leading To Burnout And Suicidal Thoughts (scienceblog.com)

Women surgical residents suffer more mistreatment than men, which leads to a higher burnout rate and more suicidal thoughts among female residents, reports a new Northwestern Medicine study that surveyed trainees in all accredited 260 U.S. general surgical residency programs. But when the study authors adjusted for the occurrence of mistreatment (discrimination, harassment, abuse), the rates of burnout were similar for men and women residents. The paper was published Oct. 28 in the New...
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Young adults with PTSD may have a higher risk of stroke in middle age (UNC Healthcare)

Karen Clemmer ·
Lindsey Rosman, Ph.D., assistant professor in the division of cardiology, is the lead author of the study, the story was published on Oct 17, 2019, for UNC Healthcare and UNC School of Medicine. CHAPEL HILL, N.C. — Oct. 17, 2019 — Young adults who suffer from posttraumatic stress disorder (PTSD) may be more likely to experience a transient ischemic attack (TIA) or major stroke event by middle age, raising the risk as much as other better-known risk factors , according to new research...
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12 Things I Wish My Doctor Understood About Childhood Trauma

Anna Runkle ·
It doesn’t happen that often anymore, but one place where I almost always get triggered with my Childhood PTSD symptoms is when I visit the doctor. I could never even put this into words before. But now that I’m mostly healed from my Childhood PTSD symptoms, I want to express what I wish my doctors – all the doctors of my life – had understood about the effects of Childhood trauma, about me. Note: This is one of my most personal posts ever. Unless you’re someone who really prefers text, I...
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7 Ways to Help a Child Deal with Traumatic Stress

Hilary Jacobs Hendel ·
Traumatic stress feels awful. Thankfully, there are small things we can all do to help relax a hyperaroused nervous system.
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A Nurse Survivor Shares Her Story and Concerns

Laneita Williamson ·
Yesterday was another trauma informed care training to nurses. I'm still very amazed at the biases that occur around sex, drugs, abortion, alcoholism, mental health or other challenges. As typical I received a follow up email from a survivor with their thoughts, not about the training but about the response of other humans around human behaviors and actions. The nurse survivor that emailed me felt so empowered to make a change that she has requested that I share her story with others in the...
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ACEs & African Americans Community on ACEs Connection

ACEs Connection envisions a resilient world where ALL people thrive. We are an anti-racist organization committed to the pursuit of social justice. In our work to promote resilience and prevent and mitigate ACEs, we intentionally embrace and uplift people who have historically not had a seat at the table. ACEs Connection celebrates the voices and tells the stories of people who have been barred from decision-making and who have shouldered the burden of systemic and economic oppression as the...
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Action needed today by trauma advocates to urge Congress to address mental health and trauma in current COVID-19 legislation

The follow is a message from Dan Press, Legal Advisor to the Campaign for Trauma-Informed Policy and Practice ), about the need to contact Congress regarding a COVID 19 funding bill being considered this weekend. He is urging ACEs science/trauma advocates and leaders to send emails to their U.S. Senators and Representatives immediately to address the mental health and trauma implications of this pandemic. All – I hate to bother you on a Sunday, but we urgently need you to contact Congress to...
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Announcing Trauma and Resilience Competencies for Nursing Education

Kathleen Wheeler ·
The authors are pleased to announce the Trauma and Resilience Competencies for Nursing Education. These competencies serve as a guideline of minimal expectations and reflect essential knowledge, skills and behaviors for three levels of nursing education: 1) undergraduate, 2) graduate, and 3) psychiatric nurse practitioner programs. The Trauma and Resilience Competencies, developed in 2018 at the Egan School of Nursing and Health Studies at Fairfield University in Connecticut by an Expert...
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At the scene of a house fire, ACEs cast long shadows

Peter Chiavetta ·
I am on the scene of a house fire in a town near where I live in Brant, NY. As part of my duties as EMT with my fire company ambulance (I'm first assistant chief firefighter), I make sure firefighters who are working a fire stay healthy while they’re fighting it, especially firefighters with ACEs.
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California unveils ACEs Aware initiative to screen for trauma

Laurie Udesky ·
Will screening for adverse childhood experiences (ACEs) in California be mandatory? No, but it’s recommended. Will there be training for physicians and staff on how to screen? Yes. Who will be reimbursed for screening patients in California? Physicians who serve patients in the state’s Medi-Cal program — for now. For more answers to these and other questions that surfaced during a Dec. 4 webinar introducing Californians to a new statewide initiative, read on. Come January 1, California will...
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Cancer as a survivor

Christine Cissy White ·
Many people use the phrase CPTSD to stand for PTSD from complex trauma. To me, C-PTSD means cancer and PTSD. I have cancer and I’m a trauma survivor. I’m a survivor with cancer but not yet a cancer survivor. Will I be a survivor squared?
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CenteringParenting Recognized as Innovative Pediatric Intervention in New Report from The Center for the Study of Social Policy [globenewswire.com]

By Vandana Devgan, Centering Healthcare Institute, November 15, 2019 Centering Healthcare Institute (CHI) is honored to share that its pediatric group care model CenteringParenting®, has been recognized by The Center for the Study of Social Policy (CSSP) as an innovative pediatric intervention in its latest study. "Fostering Social and Emotional Health: Common Threads to Transform Everyday Practice and System" , released as part of the Pediatrics Supporting Parents (PSP) initiative, shares...
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Child Abuse Doc: We Often Wish for a Different Explanation [medpagetoday.com]

By Antoinette Laskey, MedPage Today, December 1, 2019 I always knew I wanted to be a doctor. I also always knew working with children is what brought me the most joy. Finding the subspecialty of child abuse pediatrics was not something I had anticipated. In medical school, I had the opportunity to work with a child abuse pediatrician when a child was brought in for medical care after being sexually assaulted. We examined the child, calmed the obviously distressed parent, and talked with the...
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COVID-19 and Healthcare worker's families: behind the scenes of frontline response [thelancet.com]

By Amine Souadka, Hajar Essangri, Amine Benkabbou, et al., EClinical Medicine, May 17, 2020 During the COVID-19 outbreak, healthcare professionals are exposed to a high-risk of infection and mental health problems, but also fear of contagion and spreading the virus to their families. In fact, considering them as individuals implies looking beyond their function as frontline responders and taking into account their societal role as parents, spouses and offspring. While work-family balance is...
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Cultivating Deliberate Resilience During the Coronavirus Disease 2019 Pandemic [jamanetwork.com]

By Abby R. Rosenberg, JAMA Pediatrics, April 14, 2020 Coronavirus disease 2019 (COVID-19) is affecting our health care community in unprecedented ways. As a pediatric oncologist who studies resilience in the context of illness, I started thinking about what this pandemic means for our professional resilience a few weeks ago, when the first US patient with fatal COVID-19 died in my home city of Seattle, Washington. Promoting resilience among health care workers and organizations starts with...
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Donna Jackson Nakazawa on bringing down the stress-threat response

Christine Cissy White ·
Cissy's note: Donna Jackson Nakazawa has graciously allowed me to cross-post some of her current and future Facebook page posts here in the Practicing Resilience for Self-Care and Healing community on ACEs Connection . Hello Friends. As a SciComm journalist with 30 years of reporting and 6 books under my belt, which focus on how our stress response governs our immune health, I’ve been thinking about what I have learned, and how I might help you quiet your body and mind during this # pandemic...
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Doulas & Covid-19: A toolkit for doulas (DONA International)

Karen Clemmer ·
Please the attached toolkit for more information. From the toolkit: Best practices when working with clients Given how new this virus is, we currently have very little data on how it might affect pregnant people and newborns. Guidelines from the CDC outline recommendations for how to support pregnant and laboring people with Coronavirus. (3) There is currently no evidence that the virus is spread from mother to baby in utero, or that it is transmitted in human milk. (4)
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During COVID-19: The need for your skills. Self-care resources. Share your TI responses? Thank you!

Mimi graham ·
Dear Trauma F riends and C olleagues: The COVID 19 pandemic offers a critical opportunity to share your unique skills in coping with stress and trauma. Many of us and the families we serve may be shifting through the stages of change and grief----denial, anger, bargaining, acceptance---about this pandemic. You may be adjusting to telehealth and virtual visits but know that our families need your reassurance and help in regulating and coping. Hope you’re all practicing self-care while you...
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Governor Cuomo’s Cancer Research Initiative Disappointing. No ACES included.

Peter Chiavetta ·
I attended the presentation of Governor Cuomo's Cancer Research Initiative at the Buffalo Science Museum October 22, 2019. Brad Hutton Deputy Health Commissioner State of NY presented. Erie County Health Commissioners in attendance. It had all the data on the 4 major cancers in the East Side of Buffalo, NY. https://www.health.ny.gov/diseases/cancer/cancer_research_initiative/docs/erie_presentation.pdf I'm all excited. Prepared with 2 dozen ACE handouts. Sat quietly for the 45 minute power...
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How Can a Doctor Stop from Burning Out in the Pandemic? (greatergood.berkeley.edu)

Over the din of the negative pressure machine, I shouted goodbye to my patient. I zipped my way out of one of the little plastic enclosures in our emergency department (ED). With disgust and a bit of fear, I carefully shed my gloves, gown, and face shield. Only my precious mask remained on my face. I thought, This is a whole new world, and I hate it . The problem is that I’m losing that deep feeling of connection with patients, which is such an important part of this work. A few weeks ago,...
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How do these pediatricians do ACEs screening? Early adopters tell all.

Laurie Udesky ·
Last week, three pediatricians — with a combined experience of 15 years integrating ACEs science into their practices — reflected on the urgency they felt several years ago that prompted them to begin screening patients for childhood adversity and resilience when there was practically no guidance at all. Along their journey , they accumulated a list of lessons learned for other pediatricians and family clinics to use. The three pediatricians participated in the ACEs Connection webinar,...
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How trauma-informed care promotes healing: Patient Narrative

Megan Gerber MD MPH ·
So pleased that KevinMD published this patient narrative. I was encouraged to share it here as well! https://www.kevinmd.com/blog/2...romotes-healing.html By MEGAN R. GERBER, MD | CONDITIONS | JULY 26, 2019 As physicians, we face the formidable task of working with patients who appear angry, never content with care or “made better” by anything we do. They may be known as “difficult,” unpleasant, or demanding. These patients are the most challenging and often the least rewarding to care for.
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Hundreds of Miles From Home, Nurses Fight Coronavirus on New York's Front Lines [nytimes.com]

By Jenny Gross, The New York Times, April 28, 2020 Each night at dusk, in an otherwise desolate Times Square, hundreds of nurses in blue scrubs gather to board buses that take them to hospitals across New York City. Of the thousands of nurses who have come from other states to shore up New York’s hospitals, more than 4,000 are staying in Midtown Manhattan. During the day, many rest at their hotels, amid darkened Broadway marquees, quiet streets and boarded up shops. At night, they face...
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`I'm never going to be the same': Medics grapple with mental trauma on COVID-19 front line (msn.com)

Anne Messman, a veteran emergency room physician in Detroit, knew something was wrong when she developed insomnia and became unusually irritated with people she loved. Messman and thousands of other healthcare workers across the United States are grappling with psychological traumas that mental health professionals say are more commonly associated with soldiers returning home from far-flung battlefields. The unrelenting horror of COVID-19 has exacted a toll on healthcare workers who have...
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Mount Sinai Announces Center for Stress, Resilience and Personal Growth [newswise.com]

Newswise — (New York, NY – April 30, 2020 ) -- Mount Sinai Health System (MSHS), one of New York’s largest integrated health systems, announced today the launch of the Mount Sinai Center for Stress, Resilience and Personal Growth, a first-of-its-kind initiative in North America that is designed to address the psychosocial impact of COVID-19 on the mental health and lives of frontline health care providers at Mount Sinai and will serve as a model for institutions and communities around the...
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My son was hospitalized and now he has PTSD

Stephanie Kennelly ·
“Grant, do you remember when you were in the hospital?” “Yes… they came to take the blood and I turned into a werewolf.” Original Post It happened quickly. A year ago my three year old had a collarbone fracture, it became infected and within 24 hours the situation was emergent. A week long hospital stay, one month with a PICC line and two months on oral antibiotics. Finally, the labs finally came back normal. The X-Ray was clean. Gillette Children’s Hospital closed our case. But the healing...
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NPPC's Pilot Site Case Studies: Lessons Learned from ACEs Screening Implementation

Molly Peterson ·
The Center for Youth Wellness' National Pediatric Practice Community on ACES (NPPC) is a co-designed community committed to collaborative learning. To promote this learning, we have been working with six pilot sites over the last year, representing practices of various sizes and service delivery settings, to implement ACEs screening and intervention. Beyond supporting these practices with the logistics of implementation, the broader goal was to discover and share real-world best practices,...
 
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