creating trauma responsive communities - …rhat.org › resources › documents › haas - trauma...
TRANSCRIPT
![Page 1: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/1.jpg)
Creating Trauma Responsive Communities -Systems of Care that Work
May 3, 2019
Becky Haas, Trauma Informed Administrator
Ballad Health
![Page 2: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/2.jpg)
Understanding ACEs
May 3, 20192
![Page 3: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/3.jpg)
Impact of ACEs
May 3, 20193
![Page 4: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/4.jpg)
Trauma and Brain Development
May 3, 20194
![Page 5: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/5.jpg)
Moving from Awareness to Action
Implementing Trauma Responsive Services; SAMHSA Forum
2014
SAMHSA released a concept paper entitled Concept of Trauma and Guidance for a Trauma-Informed Approach
Recommendation:
“…communities (should) address trauma through a multi-agency public health approach inclusive of public education and awareness, prevention and early identification and
effective trauma-specific assessment and treatment.”
May 3, 20195
![Page 6: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/6.jpg)
Implementing Trauma Responsive Services; SAMHSA Forum
Spring 2018“Though many communities across the nation are beginning to implement some of these SAMHSA recommendations, Johnson City clearly stands out as a leader in
embracing this model.”
~ Dr. Joan Gillece, Director
SAMHSA-funded National Center for
Trauma Informed Care
September 5, 2018 hosted a Forum in Johnson City to tell our story. First Ladies Crissy Haslam and Tracey Carney attended
May 3, 20196
Moving from Awareness to Action
![Page 7: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/7.jpg)
Why educate your community about ACEs?
Eradicating child maltreatment (mitigating ACEs) in America could potentially reduce many things predicted by ACEs:
1. Alcoholism and drug use
2. The need for incarceration
3. Homelessness
4. Depression
5. Suicide
6. Domestic violence
~ SAMHSA Trauma Informed Approach
May 3, 20197
![Page 8: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/8.jpg)
SAMHSA, the Center for Disease Control and the Hazelden Betty Ford Foundation all indicate ACEs are a significant risk factor leading to addiction.
“Over half of adult Tennesseans reported at least one ACE between 2014 and 2017, and about 17% had
experienced 4 or more.”
“In 2017, ACEs among Tennessee adults led to an estimated $5.2 billion in direct medical costs and lost productivity from employees missing work.”
~ The Economic Cost of ACEs in Tennessee, Medical Costs and Worker Absenteeism from Health Issues
Attributed to Adverse Childhood Experiences. The Sycamore Institute, February 1, 2019
May 3, 20198
Why educate your community about ACEs?
![Page 9: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/9.jpg)
Imprisonment has not reduced state drug problems
May 3, 20199
1. 2014 Pew Charitable Trusts Report - prison data shows no evidence that incarceration reduces drug misuse
2. The absence of any relationship between states’ rates of drug imprisonment and drug problems suggests that expanding drug imprisonment is not likely to be an effective national drug control and prevention strategy
3. Study compared 2014 data from Tennessee and New Jersey. Tennessee drug imprisonment rank is 5th while New Jersey ranked 45th. Yet both states have comparable drug use rates.
~Pew Charitable Trust
Issue Brief, March 8, 2018
![Page 10: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/10.jpg)
Trauma and Homelessness
1. The SHIFT Study, conducted by the National Center on Family Homelessness, identified trauma as one of the top two predictors for long-term residential instability. ~ SAMHSA website April 2016
2.Childhood adversities are found to be substantially overrepresented in homeless samples, and a history of childhood adversity has been related to particularly poor outcomes among the homeless.” ~ American Journal of Public Health, Dec. 2013
May 3, 201910
![Page 11: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/11.jpg)
Improving Community Health
In a subsequent study to ACEs involving 125,000 patients, Drs. Felittiand Anda, found that those who completed the ACE Study questionnaire as part of their medical history and discussed their ACE Scores with their doctors had a 35% reduction in their doctor visits and an 11% reduction in emergency room visits over the course of the following year.
~ Felitti & Anda (2010). The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders and sexual behavior: implications for healthcare.
May 3, 201911
![Page 12: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/12.jpg)
Getting on Board - Public policymakers are catching on to science of toxic stress
Prestigious organizations collecting and reporting on data
May 3, 2019 Presentation Title12
![Page 13: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/13.jpg)
The prevalence of trauma
May 3, 201913
Around 65% of all substance abuse treatment clients report experiencing childhood abuse
Around 75% of women in substance abuse treatment report a history of trauma
Around 92% of homeless mothers have severe trauma histories
71% of children are exposed to violence each year
3 million children are maltreated or neglected each year
1 in 4 girls & 1 in 6 boys are sexually abused before adulthood
In a study of juvenile justice settings, 94% of children had experienced trauma
![Page 14: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/14.jpg)
Trauma is not an excuse
May 3, 201914
Adverse Childhood Experiences are not an excuse for drug addiction or criminal behavior –but rather provide an explanation for it.
What is predictable, is preventable.
![Page 15: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/15.jpg)
Why create a community-wide system of care?
1.Most systems engage with victims of trauma
2. If a child is experiencing ACEs at home, it’s unlikely the child will be brought by the parent to see a mental health professional right away
3. However the child by law DOES have to go to school and may be enrolled in afterschool programs. Both can become trauma responsive.
4.TIC awareness needs to be included in all frontline services in order to mitigate the effects of ACEs.
May 3, 2019 Presentation Title15
![Page 16: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/16.jpg)
Community can make a difference
1. If children are living in a home subject to ongoing, toxic stress, we can mitigate the effects of these ACEs by having a trauma-responsive community.
2. Convey by training that you don’t have to be a therapist to be therapeutic.
3. Supportive relationships are the evidence-based practice shown to heal the effects of trauma.
May 3, 201916
![Page 17: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/17.jpg)
Benefits of a system of care
1. Individuals are very often involved across a wide spectrum of services. All service providers need to speak the same language and share the same understanding of trauma.
2. Agencies collectively and individually can champion resilience for clients served.
3. Community members will experience a reduction of re-traumatization by service providers
May 3, 2019 Presentation Title17
![Page 18: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/18.jpg)
Lessons Learned from the Johnson City System of CareHow We Began
1. 2014 First learned about Trauma-Informed Care
2. 2015 Attended 2 national conferences hearing Dr. Felitti and Dr. Joan Gillece and
became convinced educating our community was urgently needed
3. “The Notebook” - Created a large binder representing every kind of police
community partnership (i.e. juvenile justice, schools, advocates, healthcare,
housing, etc.)
4. Police are educators and have many community partners
May 3, 2019 Presentation Title18
![Page 19: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/19.jpg)
Collaboration
Becky Haas
Director, Community Crime Prevention Programs, Johnson City Police Department
Now – Ballad Health
Strengths: Training development, networking and building capacity among system partners, and organizational coaching
May 3, 2019 Presentation Title19
Andi Clements, PhD
Professor, Department of Psychology, East Tennessee State University
Strengths: Survey instrument development, data collection, data analysis, grant writing and organizational coaching
![Page 20: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/20.jpg)
Creating the “system”
May 3, 2019 Presentation Title20
![Page 21: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/21.jpg)
SAMHSA’s “Trauma-Informed Approach, Key
Principles and Assumptions”
1. 4 hour introduction to trauma and trauma-informed approaches. No prior knowledge about trauma is necessary.
2. Intended for a wide range of professionals
3. Forms the basis for more advanced work
4. Non-prescriptive
5. SAMHSA six pillars provide building blocks where to start in making an application
6. Provide trainees with practical examples of application in their setting
7. Training leaves participants with an expectation of use
8. Evaluation includes a commitment to make application within a self-imposed deadline
9. Developed dozens of variations of this training
May 3, 2019 Presentation Title21
![Page 22: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/22.jpg)
Community Saturation
1. No progress is too small
2. Train the trainer – 6 hour course
3. Organizations prepare for ongoing training for their employees
4. Trauma-Informed Care training is not “taught” but it’s “caught.” It needs to be shared with passion. Are you contagious?
5. Community Forums – film screenings, discussion groups, etc.
6. Identify community ACE Champions
7. Don’t forget to measure
May 3, 2019 Presentation Title22
![Page 23: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/23.jpg)
Johnson City Timeline
August 2015 Conference Call with SAMHSA’s National Center for
Trauma Informed Care to strategize
October 2015 Drs. Joan Gillece and Brian Simms provide training to 383 professionals at DP Culp
Center
January 2016 NCTIC provides “Key
Assumptions” draft course
May 3, 2019 Presentation Title23
![Page 24: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/24.jpg)
Becoming Trauma Informed is not a destination…it’s a journey
Spring of 2016 began to offer trainings to area
professionals
Summer of 2018 over 4,000 trained locally
June 2016 started bi-monthly Trauma-Informed System of Care meeting
April 2016-July 2018 64 trainings, 2 Paper Tigers
screenings, dozens of community talks and 146
trained in 4 Train the Trainer events
May 3, 2019 Presentation Title24
![Page 25: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/25.jpg)
Bi-Monthly System of Care meetings
May 3, 2019 Presentation Title25
Key to moving from training to culture change – awareness to action
System affiliation does not require an MOU
Meetings include coaching and cheering
Johnson City System of Care now has over 50 agencies affiliated
Bristol, TN has launched a second area System of Care
Kingsport, TN and Smyth County Virginia are having early conversations
Writing a toolkit for the state
![Page 26: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/26.jpg)
The Continuum of Care
• Trauma-Aware: Organizations aware of how prevalent trauma is and begun to consider that it might impact their clientele and staff.
• Trauma-Sensitive: Organizations have begun to 1) explore SAMHSA’s Six Principles of Trauma-Informed Organizations ; 2) build around the principles; 3) consider the adopting the principles; and 4) prepare for change.
May 3, 2019 Presentation Title26
• Trauma-Responsive: Organizations begin to change their culture to highlight the role of trauma and resilience. All levels of staff are re-thinking routines and infrastructure of the organization.
• Trauma-Informed: Organizations have made trauma-responsive practices the norm. The trauma model no longer depends on a few leaders. Organization partners with other agencies to strengthen trauma-informed practices community-wide.
![Page 27: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/27.jpg)
Cheering the Progress
May 3, 2019 Presentation Title27
![Page 28: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/28.jpg)
Topper Academy
May 3, 2019 Presentation Title28
![Page 29: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/29.jpg)
Law Enforcement
May 3, 2019 Presentation Title29
POST Certified Trauma Informed Policing Training
Training for LEO in growing demand
Oklahoma City PD this summer
Implementing Handle With Care in partnerships with police and schools
Handle With Care – Johnson City, Erwin, Elizabethton, Hancock County, Sullivan County, Johnson County, Bristol, TN, and Lee County, VA
![Page 30: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/30.jpg)
ETSU Brain Trust
Building Resilience through ACEs Informed Networking (BRAIN) Trust.
• College of Medicine: departments of pediatrics and psychiatry (and the center of excellence for children in state custody, which is in psychiatry)
• College of Arts and Sciences: departments of psychology and biological sciences
• College of Pharmacy: department of pharmaceutical sciences
• College of Education: department of counseling and human services and the center of excellence for early childhood learning and development
• College of Public Health: department of biostatistics and epidemiology
May 3, 2019 Presentation Title30
![Page 31: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/31.jpg)
Ballad Health Trauma Informed Strategies
Strong Starts for Schools
Schools receiving training before 2019-2020 school year: Erwin, Elizabethton City, Johnson, Hancock, and Buchanan Counties, Bristol VA
Systems of Care
Johnson City and Bristol, TN
Trauma Responsive Workforce
Resiliency Centered Healthcare – 1st hospital trained by end of April (21 hospitals/18,000 team
members)
July 11 – First Conference planned
May 3, 2019 Presentation Title31
![Page 32: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/32.jpg)
Questions
May 3, 2019 Presentation Title32
![Page 33: Creating Trauma Responsive Communities - …rhat.org › resources › Documents › Haas - Trauma Informed...inclusive of public education and awareness, prevention and early identification](https://reader034.vdocuments.mx/reader034/viewer/2022042401/5f10a63a7e708231d44a2502/html5/thumbnails/33.jpg)
Contact Information:
Becky HaasTrauma Informed AdministratorBallad [email protected]
May 3, 2019 Presentation Title33