Addressing the lifelong effects of trauma

Staff Writer
Educators, mental health professionals and other community leaders are about to conclude a year of education on how to make Hancock County more sensitive to the needs of people who have suffered trauma. But, they say, the work is just beginning.
The Hancock County Trauma-Informed Learning Community Team, originated by the Be Healthy Now coalition and the Hancock County Board of Alcohol, Drug Addiction and Mental Health Services, includes representatives from schools, mental health, law enforcement, social service agencies and other nonprofit organizations. Their goal is to address long-term problems that may grow out of trauma.
Research over the past 20 years has shown that children who experience multiple traumas in their life will, even as adults, be more likely to have addictions or mental illnesses and more likely to attempt or commit suicide, said Dr. Mark Hurst, medical director for the Ohio Department of Mental Health and Addiction Services.
Trauma also affects overall physical health, he said. Someone who has suffered trauma is more likely to get cancer or heart disease or die prematurely. In addition, autoimmune diseases, diabetes and obesity are linked to trauma, said Karen Johnson, director of trauma-informed services for the National Council for Behavioral Health. Johnson, based in Washington, D.C., traveled to Findlay twice to train area professionals in trauma-informed care.
Hurst said these illnesses may be the result of the impact of trauma on the developing brain, as well as trauma creating chronic inflammatory processes which can lead to both mental and other physical illness.
Johnson said when a person suffers trauma it affects their “stress response system” which will become overdeveloped and then “defaults very readily then to that fight, flight or freeze response,” even when there is no threat. It also affects the immune system.
Researchers have found the prevalence of trauma within homes, communities and families is “much higher than we had perhaps thought,” Johnson said. The Adverse Childhood Experiences study, a study of 17,000 participants in the 1990s, made professionals more aware of the prevalence of trauma and its impact on those who survive it.
Amber Wolfrom, director of planning and accountability systems for ADAMHS, said she has heard it explained as “Trauma trumps all.” That is, if a person is a survivor of trauma, even using well-researched theories to try to help them won’t be effective unless the trauma is addressed.
So when the Be Healthy Now coalition, which is in charge of the community health assessment, identified obesity, substance abuse and violence as three health issues they most wanted to work on, it made sense to bring “trauma-informed care” to Hancock County, Wolfrom said. Handbags That Help gave a $30,000 grant and the ADAMHS board added another $10,000 to create the Hancock County Trauma-Informed Learning Community Team. The money allowed ADAMHS to contract with the National Coalition on Behavioral Health. The goal was to not just have a one-time training but “immerse the community in this learning experience,” Wolfrom said.
The agencies involved have held meetings as a group but have also each on their own come up with ways to address trauma.
Findlay City Schools is training teachers and staff on trauma.
Superintendent Ed Kurt said schools in Findlay, like schools nationwide, are seeing more trauma-related issues, and these keep kids from being able to get “to a point where they could learn.” Not only teachers but all staff — including bus drivers, cooks, lunch monitors and anyone who may come into contact with a child — will attend the trainings, which will include role playing as well as lectures.
Kurt said the sooner a situation is addressed, rather than letting it grow worse, the better.
Kelly Glick, assistant principal at Donnell Middle School, said not only can trauma affect an individual’s health, but it even has economic implications, as a “tremendous” amount is spent on services for these adults.
Glick said a school district in Washington state did something similar to what Findlay City Schools plans, but on a smaller scale, and found that their rates of discipline and suspension decreased dramatically.
Another agency involved in the trauma-informed care initiative is Focus on Friends. Once a drop-in center for people with chronic mental health issues, it is now making the transition to becoming the community’s recovery center.
This change includes a face-lift. Executive Director Wayne Ford said Focus on Friends’ goal is to create an environment that is “warm and welcoming” by changing paint colors to give the building a less institutionalized look.
Also as part of the effort to become more trauma-informed, Focus on Friends has “changed our language,” Ford said. This includes emphasizing words like “mental health” rather than “mental illness.”
“We want to be inclusive,” he said. “We want everybody in Findlay to feel that they can come here.”
Of people with addiction or mental health issues, “90 percent of them have had some form of trauma in their early childhood,” Ford said.
This may affect their reaction to things that might not bother others. Hearing someone raise their voice might provoke a strong reaction if someone in their childhood raised their voice before a violent or abusive situation. Even the words “you’ll be safe” can be difficult if “their perpetrator used those words,” Ford said.
Jennifer Swartzlander, executive director of Children’s Mentoring Connection, said her agency looks at trauma from a non-clinical perspective. She said mentors and case managers are learning how to support children who may have been through a trauma. In October, Children’s Mentoring Connection is hosting a presentation on the topic.
Swartzlander previously worked at Hope House, and had seen the results of trauma there, but she has learned about it from a new perspective. Trauma could include the loss of a parent, going to foster care or sexual abuse, as well as things like a family divorce. The sooner a child gets proper treatment or care, the greater the likelihood that their challenges can be reduced or minimized.
Swartzlander said another thing that came out of the yearlong effort is that a wide variety of agencies including law enforcement, social service agencies and the schools are all working together.
“All of those groups were part of this work, and so we all have a common language and we have a common knowledge,” she said.
Johnson said the work Hancock County professionals have done in the past year will give them tools so they can continue this process, and can determine what to do next to continue learning about the issue while bringing “more and more partners to the table.” The formal coaching from Johnson and others will come to an end but Hancock County participants will have ongoing access to the national council’s email list and webinars.
Johnson said a goal should be “moving the question from ‘What’s wrong with you?’ to ‘What happened to you?'” She said it’s important to understand that a person’s behavior may be a result of what has happened to them.
ADAMHS has received an additional $35,000 grant from the Ohio Department of Mental Health and Addiction Services to continue the effort.
Wolfrom said that this is not simply a one-year project but will be an ongoing process. She said agencies that did not participate in the past year, but want to learn more about trauma-informed care, can contact ADAMHS, which is serving as a clearinghouse for this information.
Johnson said it’s vital that everyone — not just clinicians and therapists but others in the community — be trauma-informed.
“There needs to be a sense of urgency around this work,” she said.
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