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legal 246Legislating to become trauma-informed 

I wanted to follow up on an earlier blog about Adverse Childhood Experiences (ACEs) and future health.

This blog described a study which has been replicated many times which found that there was a direct link between childhood trauma and adult onset of chronic disease, as well as mental illness, doing time in prison, and work issues, such as absenteeism. More adverse childhood experiences resulted in a higher risk of medical, mental and social problems as an adult.

As a result, some communities are wanting to become trauma-informed - teaching parents not to pass on ACEs. See another blog here; How a community becomes trauma-informed.

There are now various initiatives progressing in the UK with several churches having public showings of the film 'Resilence' and discussing actions. In Scotland, a movement is underway to make Scotland the first ACE Aware nation with a national conference planned for Sept 2018.

In the initial blog, I informed that, with the results of all the research, trauma-informed practices are rising in the U.S., Canada, and countries in Europe, Asia, and Central and South America in schools, prisons, mental clinics and hospitals, etc.

I also asked the question, 'How do we make sure in our systems of education, criminal justice, etc that we don’t further traumatize someone who’s already traumatized?'  Could we influence our institutions to be 'trauma-informed'?

There is now some further information about how the USA are now introducing state and federal legislative, regulatory, and contracting policies aimed at reducing trauma and toxic stress and promoting resiliency and trauma-informed practices in institutions. 

A March 2017 scan by the National Conference of State Legislatures (NCSL) found almost 40 bills in 18 states that specifically include language on ACEs, representing a dramatic increase from a scan completed in March 2016. In addition, the 2017 NCSL scan identified 20 approved statutes in 15 states that referenced ACEs and trauma-informed policies and practices.

These bills and statutes — from states across the USA — promote a variety of trauma-informed practices, such as: screening for ACEs; training staff and providers; and creating safe and supportive environments. They also address implementing trauma-informed processes within a number of health and social service systems, including: health care; behavioral health; child welfare; juvenile/criminal justice; education; and early childhood.

Examples of state-level support for trauma-informed practices include:

  • Legislation to include trauma screening under the Health Service Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT);
  • Social and emotional screenings as part of school entry examinations;
  • Home health care professionals to use the ACEs questionnaire to assess a patient’s health and health risks, with a tie to funding to use of the questionnaire;
  • A State juvenile justice department must provide trauma-informed training for juvenile probation and supervision officers;
  • Encouraging state colleges and universities to include ACEs and the impact of trauma in their curricula;
  • Funding for public agencies and nonprofits in deprived areas to reduce and prevent the incidence of ACEs.

The Trauma-Informed Care for Children and Families Act of 2017 now going through Congress and Senate aims to increase understanding and awareness of trauma and identify best practices for prevention and treatment. The bill proposes to:
(a) support workforce development, test new trauma-informed strategies, improve data collection on ACEs, and promote trauma-informed service delivery;
(b) pilot a healthcare program to incentivize coverage of trauma-informed screening and treatment;
(c) increase funding for evaluation of new strategies and foster coordination of cross-sector efforts.
The bill has received significant support from a number of national, state, and local organizations, indicating growing awareness of the impact of trauma on health and behaviour and the need for it to be addressed. 

There is also a move to designate a national trauma-focused awareness month and day. 

If you are involved in policy formation at a national or local level, why not review these examples and see how they could be applicable to your context?

What about your church scheduling a public showing of 'Resilence' - something to invite local parents to?

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Geoff Knott, 15/11/2017

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