The dose-response relationship between adverse childhood experiences (ACEs) and mental illness is a public health concern. Findings from literature have illustrated the importance of early interventions in order to alleviate the effects of ACEs and improve children’s development (Felitti et al., 1998). The proposed grant seeks to explore ACEs in children aged 12-17 years old in Leon County, Florida. The provision of mental and physical resources at various levels of the social ecological model are expected to increase positive developmental outcomes in this target audience. With assistance from physicians, behavioral therapists, community leaders, parents, and local school staff, trauma-informed care and activities that increase resilience (e.g. meditation and journaling) are expected to improve individual and community health.
Trauma-Informed Principles
The Substance Abuse and Mental Health Administration’s (SAMHSA) principles will be applied to achieve the proposed goals for this project. In creating an environment that allows for children aged 12-17 years old to be comfortable speaking about mental health, and providers a safe space to recommend the use of mental health resources, physical and psychological safety is maximized. To do this, careful consideration of location for provision of services will be evaluated. A natural environment such as a local park with ground rules for a judgement-free zone may be established. Cultural, historical, and gender issues will be addressed through clear communication on the stance of project developers regarding culture and individual identities. Stereotypes and biases will not be reinforced, and services will be individually tailored to meet the needs of each child aged 12-17 years old. To meet the principle of trustworthiness and transparency, the goals of this project as well as resources, and staff qualifications will be communicated to children aged 12-17 years old, in addition to their parents and guardians. Collaboration and mutuality through interactions amongst each diverse member of the target audience in project activities will reinforce a child’s resilience. Shared experiences will be accepted and acknowledged. Increased peer support will supplement previously mentioned principles for this project (e.g. safety and trustworthiness). Project activities will promote an awareness of mental health and support from others that will empower the target audience. The incorporation of the above-mentioned principles for this project will help better meet the mental health needs for children aged 12-17 years old.
Levels of the Social Ecological Model
The social ecological model illustrates the various factors that may contribute to an individual’s health. For this proposal, the Center for Disease Control and Prevention’s social ecological model will be referenced. In this model, there are four levels: individual, relationship, community, and social (Centers for Disease Control and Prevention, 2022). Each level overlaps, demonstrating the bidirectional influence each level has on another. At the individual level, this project will educate our target audience, children aged 12-17 years old, on mental health and its impact on overall health. The subject of resilience will be discussed, in addition to strategies that may build resilience and improve mental health. In this way, children aged 12-17 years old may better cope with adverse childhood experiences and reduce its effects on their overall health. At the relationship level, parents, friends, and teachers will be trained on ways to recognize mental illnesses in children aged 12-17 years old, in addition to the availability of resources and strategies for building resilience. While it is important to educate our target audience, support from friends and family may aid in the maintenance of behaviors that improve overall health. At the community level, clinical care that promotes and includes the use of mental health resources (e.g. screenings) will be requested and encouraged. Despite mental health stigma in a community, interventions at this level will reduce negative outcomes such as community violence. Addressing various levels of the social ecological model for this project will assist with the maintenance of changes proposed, as well as inspire change at a population level.
Public Health Framework
To achieve the goals of this project, a multidisciplinary, public health approach will be considered. In developing activities and resources for the target audience, community leaders and members of local health departments will be contacted to better understand audiences’ needs. Policymakers will be contacted to evaluate policies (if any) addressing ACEs and trauma, and protections for youth aged 12-17 years old who are seeking mental health resources. School staff will be trained on mental health for children. The use of a public health framework ensures that the communities of the target audiences’ grow in parallel. In addition to increasing resilience in our target audience, this intervention seeks to strengthen community capacity.
In working to reduce ACEs and trauma within the community, this project will target various public health levels of prevention. At the primary level, education will be provided to parents, guardians and children regarding ACEs and building resilience (CDC, 2022). At the secondary level, school staff and primary care providers will be trained on performing mental health screenings, as well as providing trauma-informed care (CDC, 2022). Finally, at the tertiary level of prevention, schools and safe spaces (e.g. youth organizations) will offer clinical care to children experiencing ACEs and trauma (CDC, 2022). In doing so, a comprehensive project will be developed that encourages maintenance after implementation.
References
Centers for Disease Control and Prevention. (2021, April 6). Preventing Adverse childhood Experiences. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/violencepr...n/aces/fastfact.html
Centers for Disease Control and Prevention. (2021, March 22). Data and Statistics On Children's Mental Health. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/childrensmentalhealth/data.html
Centers for Disease Control and Prevention. (2022, January 18). The Social-Ecological Model: A Framework for Prevention. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/violencepr...ecologicalmodel.html
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American journal of preventive medicine, 14(4), 245-258.
Heekin, K. (2016). Mental Health Expenditures in Florida: Concerning Trends Throughout the Past Decade. Retrieved from https://claudepeppercenter.fsu...out-the-past-decade/
Jamieson, K. (2019, December 4). Aces and minorities. Center for Child Counseling. Retrieved February 13, 2022, from https://www.centerforchildcoun...s%20black%20children.
Jamieson, K. (2018, October 8). The Alarming Effects of ACEs on Our Community. Retrieved from https://www.centerforchildcoun...20all%20over%20again.
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World Health Organization. (2021, November 17). Adolescent Mental Health. World Health Organization. Retrieved from https://www.who.int/news-room/...escent-mental-health
Zarse, E. M., Neff, M. R., Yoder, R., Hulvershorn, L., Chambers, J. E., & Chambers, R. A. (2019, March 7). The adverse childhood experiences questionnaire: Two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases. Taylor & Francis. Retrieved from https://www.tandfonline.com/do...&needAccess=true
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