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Grassroots resilience: Rural communities tackle ACEs


Rt to left—Adrienne Coopey, DO, Billings Clinic, MT, Lorenzo Lewis, The Confess Project, Little Rock, Ark, and Mendy Spohn, MPH, public health administrator in several counties in Oklahoma

The three presenters for the “Grassroots Resilience: Rural Communities Tackle ACEs” workshop brought to life the unique challenges of addressing ACEs and trauma in rural communities and shared some valuable lessons for communities of any size. 

Mendy Spohn,  a public health administrator for several counties in Oklahoma, described how one community, Ardmore, had the infrastructure in place to support a healthier town, but the health status among its residents was among the lowest in the state. Stakeholders meeting around 2014 determined that the community was not addressing the whole person—brain and body—and started a community-based initiative to address ACEs.  With support from the National Council for Behavioral Health, a core team of champions—bankers, hospital leaders, non-profits and representatives of the Chickasaw Nation—began working together. Community readiness was the first focus.  The process ebbed and flowed, and people stepped up to contribute help where they had something to offer. For example, the Chickasaw Nation had what was described as a “phenomenal” integrated health program that proved to be a valuable model. It involved people who could offer input based on their own experiences with trauma. 

Lorenzo Lewis, Founder, CEO, The Confess Project—an initiative that confronts the stigma around mental health for men of color—told his compelling story about how his life trajectory was changed when he received therapy to deal with his challenging childhood. Lewis works from Little Rock, Arkansas but takes his program to cities big and small around the country.  Even though he worked in mental health, the stigma surrounding mental health in the African American community as well as in other communities kept him from being completely open about his work.  When his brother was diagnosed with bipolar disorder, mental health was brought even closer to home.  He highlighted ways to communicate about ACEs with BYMOC (Boys Young Men of Color) such as story telling, including You Tube videos where celebrities tell their own stories, and building on empathy, compassion, and mental health literacy.

Dr. Adrienne Coopey of the Billings Clinic in Montana, who had previously practiced in Asheville, North Carolina, brought the physician perspective to the panel, addressing the challenges, and opportunities of tele-psychiatry, and the value of an electronic medical record. The shortage of psychiatrists in rural areas—even if there are resources to pay for professionals—is an acute problem.  Even when tele-psychiatry is available, slow Internet connections can impede the process.  Dr. Coopey described how Melissa Baker, who passed away this year, taught her about ACEs when she became involved with the Buncombe County ACEs initiative.  She talked about how Baker patiently spread the word about ACEs and slowly gained support for ACEs-informed programs such as the Compassionate Schools program started in Washington State.

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Does it make sense to increase the number of rural psychiatrists if they continue to practice with the same trauma uninformed, drug people to death pattern? 

It doesn’t make sense. Instead  of helping a traumatized child, we make them obese, insulin resistant, increase the risk for heart attack and stroke via antipsychotic induced metabolic syndrome and give the child Type 2 diabetes. 

It doesn’t make sense. And I am hearing Dr. Perry say this more and more and more loudly and more clearly so I am not the only one. Psychiatry must change to find what works and do what works because a one size fits all approach to trauma will never work.  

Healing doesn’t come from a pill provided by a psychiatrist or a GP, it comes from Love and Safety.  

I’m in Spartanburg now. 

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