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Reply to "Trauma informed hospital system"

this list tends to be mostly "listened to" by those in child and educational settings, but for those interested in adults -- I couldn't agree more, Tina, but don't give up. I used to work (am retired now) as a clinical and forensic psychologist, with an enduring interest in Substance Abuse Treatment, and was constantly frustrated by this lack of awareness and "appropriate attention" by "The System" to patients' "real needs". Someone who might know about such health systems is Ruth Lanius, Psychiatrist / Professor, Uni Western Ontario, who wrote "The Impact of Early Life Trauma on Health and Disease: The Hidden Epidemic" (2010 - Amazon http://goo.gl/PR92Ck ). It's crucially important in adult MH and addictions -- see Kate Mills work of a couple of years ago, finding "almost all" of those presenting to acute psychiatric facilities with suicidal ideation and Substance Abuse histories had suffered some form of childhood interpersonal trauma -- attaching a link to the radio broadcast -- reveals more than the academic articles.

 

I'm retired now but when working in AOD once each year I'd ask such services if any were geared up for this sort of ACEs screening -- none were, but a couple said they were "thinking about it".  ACEs in female AOD clients are very high, in males not as high, but both much higher than in the general community. When one considers such women often end up presenting for admission to general hospitals for SU-related physical complaints while still in their 30's (men in their 40's -- relative incidence 70%/40% of such patients) one can gain some inkling of the severity and scale of the problem -- most often, never asked about, never told to anyone, and never addressed.

 

And what are we learning "these days" -- people often don't "grow out of it", or "get over it", but that elements of such concerns live for as long as the patients do -- their whole natural lives, into later years, affecting their care with dementia, and their dying days.  It is certainly NOT just a problem for pediatricians. 

 

People haven't "connected the dots", yet, but that's what we're re-learning from the latest research on Vietnam vets with PTSD arising from 40 years ago -- many of whom had histories of childhood trauma,  re-exposed to trauma in the war, and now with "intractable" disorders  --- but now such individuals are identified much earlier, and screened out of serving, so far as I know from Downunder.

 

The field has been saddled (crippled) by an over-identification with traditional ideas of PTSD due to only particular types of events, now we're realising that for people experiencing ACEs the types of events / experiences can be much broader and much more complex to understand (McDonald's paper), and that for some it can sensitise them to the effects of later adversity, and only for a few, IMHO, will they be able to enjoy "posttraumatic growth" --  It'll take at least another 5-10 years for medicine to catch up, costing  health care systems billions along the way, for "inadequate and inappropriate treatment". It's not for no good reason that van der Kolk has called childhood trauma the biggest public health problem (NOT just the biggest childhood mental health problem).

 

Good luck, best wishes

 

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