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PACEs in Nursing

Help Navigating the Road to Community Resiliency

 

The first time I ever heard the words trauma-informed care and the Adverse Childhood Experiences (ACEs) study was in the summer of 2014. At the time, I was working for the local Police Department as the Director of a grant-funded Crime Reduction Project aimed at reducing drug-related and violent crime.  Of the many program goals, one was to develop a rehabilitative corrections program for felony offenders with addictions in order to reduce recidivism.  Though I’ve lived in this region for decades, even having my own life impacted by the addiction crisis, I still had no idea how invasive the consequences were of drug addiction within our communities.  From overcrowded prisons, hospitals delivering staggering rates of babies whose mothers are addicted, to finding foster care shortfall solutions and public-school systems where I first heard phrases like, cradle to prison and school to prison pipelines.  As a mother and grandmother, I wondered who are the children that are born with a predisposition heading them into prison? 

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(Addressing ACEs Conference - keynote speaker to city leaders in Raleigh, North Carolina

Most of my career has been spent developing and implementing educational programs of one kind or another. By hearing the message that childhood adversity without having a healthy support system can not only derail brain development, but create a significant risk factor for addiction and future life and health disparities, it impacted me in a way that no other content ever had. Listening to stories of childhood abuse and neglect experienced by those previously incarcerated planted the thought in my mind that trauma was really the gateway drug. Though childhood trauma is not an excuse for drugs or crime, instead it now offered an explanation for it. I reasoned no one picks where they start in life and some of the hardship and abuse people experienced was through no fault of their own. Instead of communities focusing their efforts on a war on drugs, (which efforts don’t seem to be winning), we should shift our focus to a war on trauma. 

The addiction crisis has challenged community leaders locally to look outside the box for solutions and ACEs science and trauma informed care seemed essential, and in my mind, overlooked.  However, ACEs are not destiny and what is predictable is preventable.  The hope offered by ACEs science was that I now learned we can mitigate the effects of childhood trauma by becoming a more resilient, supportive communities.  I felt learning this was as important as if I’d learned the cure for cancer and if I did not tell my community about it, in some way, I would be held responsible.  So, with that sense of urgency, I decided to take action. 

In 2014, that the Substance Abuse Mental Health Services Administration (SAMHSA) released a concept paper entitled Concept of Trauma and Guidance for a Trauma-Informed Approach with the recommendation that communities address trauma by viewing it as an important component of effective behavioral health service delivery. Additionally, it was SAMHSA’s guidance that communities should address trauma through a multi-agency public health approach inclusive of public education. Aware of this guidance, in June of 2015, I reached out to several faculty members at our state university to see who may consider helping me educate our town about Adverse Childhood Experiences. A longtime friend and tenured Psychology professor was among that group.  Following my presentation, she agreed to help. While maintaining our busy day jobs, we managed to train over 4,000 professionals in less than three years. In September of 2018, representatives from SAMHSA, and the National Center for Trauma Informed Care, came to hear our story, along with two governor’s wives and people from twenty other states and recognized the model we created for building a trauma informed community as a best practice for other cities to replicate. 

Gov

(left to right, Delaware First Lady, Tracey Quillen Carney and former Tennessee First Lady, Crissy Haslam learning about the NE TN ACEs Connection

Shortly after this, I was invited to work for a regional healthcare system as the first Trauma Informed Administrator they had ever hired.  This opportunity only increased the valuable lessons and experience I have gained training and coaching professionals in every sector.  Over eighteen months, I passionately advanced this topic within twenty-one counties of two states adding over twenty-five thousand work related miles to my car.  As a result, numerous school districts, police precincts, juvenile justice programs, team members in one entire hospital, and community stakeholders grew in their awareness of ACEs as a necessity to improve the health of those living in rural Appalachia.  The most inspiring outcome of these efforts, is now the number of ACEs champions who have emerged and as was headlined by our local newspaper in the fall of 2019, there is now regional acceptance of the importance of ACEs science.    

Bristol proclamation3

(far left, Bristol Tennessee Mayor, Margaret Feieraebend issuing an ACEs Awareness Month Proclamation

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(Training teachers in the entire district of Buchanan County, Virginia on Creating Trauma Sensitive Classrooms

My experience is unique to the field of trauma informed care subject matter experts. In 2015 when beginning my journey to create a more resilient community, specialized training's were not available in many disciplines.  This prompted hours of research to identify peer recommendations for the best practices of a trauma informed approach within various fields and then developing training content based on these findings.  When I did find training content available, I quickly became proficient in presenting it.  These efforts led to the development of Trauma Informed Care training for police (now certified in both Tennessee and Oklahoma for officer in-service credit hours), healthcare, educators, services to homeless individuals, domestic violence programs, at risk youth programs, creating multidisciplinary teams as best practice and more.  I’m experienced at presenting the National Child Traumatic Stress Network Trauma Informed Essential Elements of a Trauma-Informed Juvenile Justice System, and Futures Without Violence, Coaching Boys into Men program.  Due to a growing demand for agencies to now offer these training's ongoing themselves, I have now developed Train the Trainer programs for several of these.     

OK CIty PD

(Training the Oklahoma City Police Department Recruit Academy and Administrative staff in Trauma Informed Policing

In 2019, I co-authored the Building A Trauma Informed System of Care toolkit for the Tennessee Department of Children’s Services.  This toolkit was developed as a result of pioneering the work to build the Northeast Tennessee ACEs Connection group.  Through funding provided by the Tennessee Building Strong Brains Program, we wrote in a very transparent fashion the steps taken, mistakes made and inspiring successes of local ACEs champions forming a community-wide System of Care.  Using stakeholder surveys, training evaluations and focus group input, the toolkit evolved.  This toolkit was designed as a road map to help other communities Advocate, Educate and Collaborate in order to bring to life a trauma informed community of their own.  The toolkit’s recommended use has since been published in John’s Hopkins journal, Progress in Community Health Partnerships: Research, Education, and Action and the global online journal ACEs Connection in Growing Resilient Communities 2.1. 

In April of this year I was honored to be invited to join the strategy team for the Campaign for Trauma Informed Policy and Practice (CTIPP) National Trauma Campaign.  By joining this effort, I’m amazed and thrilled to see the growing momentum around the topic of ACEs science.  There are grave concerns expressed by many that the isolation and quarantines needed to navigate COVID-19 will result in a trauma tsunami.  Baffling to me in my own journey to develop a trauma informed community was how for so long the warnings forecasting the effects of childhood adversity have been left unaddressed.  In 2012 the Report of the Attorney General’s National Task Force on Children Exposed to Violence stated, “Exposure to violence is a national crisis that affects approximately two out of every three of our children. In 1979, U.S. Surgeon General Julius B. Richmond declared violence a public health crisis of the highest priority, and yet decades later that crisis remains.”

We are long overdue for a national awareness campaign — similar to public health initiatives on how seat belts and car seats save lives, smoking causes cancer, and hand washing prevents the flu.  Education is needed within every professional sector on how childhood trauma leads to adult life and health disparities including addiction.  Only then can we help those who feel paralyzed by their pasts to achieve the healthy lives they deserve.  Recognizing the need to better equip professionals and cities in their journey to reduce the effects of trauma, and an astounding number of requests for training and coaching, I’ve decided now to share my experiences as a full-time vocation.  By inspiring, training or coaching, my goal is to accelerate the efforts of others in creating a trauma informed community or organization in order to mitigate the effects of childhood adversity and trauma.  If you need help navigating the road to develop a trauma informed community or organization, I'd love to help.  Please visit BeckyHaas.com.

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  • Bristol proclamation3
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