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We are building the case for investment in trauma-informed care and vicarious/secondary trauma prevention/intervention at our healthcare institution. Have any of you estimated the cost to your healthcare institution of NOT addressing this issue? 

1. Trauma Informed Care:

I understand there is much literature about ACEs and ACEs association with suicidality, adult un/underemployment, academic challenges, homelessness, poor health, premature death, etc. And we are all aware that our patient populations bring with them both past traumas as well as any acute trauma that may have occurred in relation to the reason they are seeking care (e.g., gunshot wound, sexual assault, etc.).

Has anyone attempted to calculate the cost (to their institution) of not operating with trauma-informed care principles at their institution?  Example: a social worker identified sexual assault in the early life of a patient with opioid addiction who has been in and out of recovery for years. Prior healthcare and behavioral health treatment providers (ours or other) never inquired about ACEs and other past traumas and the patient never connected that past assault with his SUD. Once identified, the patient sought treatment for the early life trauma. What costs did the institution incur by not previously identifying a significant factor in this patient's SUD or could we incur by not understanding the impact of this past trauma on the patient.

2. Same question for vicarious/secondary trauma prevention/treatment?  Have you calculated the cost of burnout, attrition, to your institution?

Thank you for any thoughts or guidance!


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The research on DNA methylation is showing that approximately 40% of the US prison population have their genetic capacity to produce Dopamine, Serotonin. etc. shut down by extended early life trauma leaving only the fight, flight or freeze genetic structure producing Adrenaline and Cortisol etc.

The cost of incarcerating this 40 % runs at $40bn per annum.

Our policy makers need to redirect this $40bn to early life care , good maternity leave provision etc.

Are you aware of the emerging genetics and neuroscience research ?

Sol Davidson



I am interested in the source for those statistics too. I tried googling keywords to try to find it, but the best I could find was β€œDNA methylation signatures of childhood trauma predict psychiatric disorders and other adverse outcomes 17 years after exposure.” (Charlie L J D van den Oord et al. Mol Psychiatry. .)

Only the abstract is free to view, the full article is pay-per-view, so I’ve only read the abstract.

There is an article (not a research paper) that touches on epigenetics (DNA methylation is one of several epigenetic mechanisms that cells use to control gene expression) and a therapist that works with prison inmates. β€œUnlocking Violent Crime Through Epigenetics” (Deutsche Welle)

Hi Eric

Thank you for your response, all helps build a coherent set of papers to circulate to an ever widening network of interested people. My interest in getting this material more widely distributed is that so few policy makers and professionals working in the field do not seem to be aware of the very significant role Epigenetics is playing on the world stage and nationally / locally ref Putin, Trump, Johnson to name just a few.

Be good to keep in touch with our various findings

Once again many thanks

Sol Davidson

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