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PACEs in Medical Schools

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One state. One year. (Partial) Cost of ACEs = $5.2 billion.

Jane Stevens ·
In looking at the impact of childhood trauma, you can’t get much clearer than this: In 2017, ACEs among Tennessee adults led to an estimated $5.2 billion in direct medical costs and lost productivity from employees missing work. That’s just one year, according to the new report, “ The Economic Cost of ACEs in Tennessee ," released on Feb. 1, 2019 by The Sycamore Institute in Nashville, Tenn. And to provide some perspective, $5.2 billion is one-seventh of the state’s annual budget . This $5.2...
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Overview of the Community Resiliency Model, used worldwide to help trauma survivors re-regulate their central nervous system, offered in two, free 90-minute webinars.

Carey Sipp ·
Elaine Miller Karas , key creator of the Community Resiliency Model (CRM), will be joined by CRM trainers from Wilmington, NC, Allison Wine , behavioral specialist, and Kelly Purcell , instructional coach and multi-tiered support specialist for this free, two-part training. Register now for two, FREE 90-minute sessions May 7 from 11 a.m. - 12:30 p.m. EST and May 14 from 11 a.m. - 12:30 p.m. EST (The complete overview requires attendance at both sessions. Registration link below registers you...
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Population-Based Analysis of Temporal Trends in the Prevalence of Depressed Mood Among Sexual Minority and Heterosexual Youths From 1999 Through 2017 [jamanetwork.com]

By Alexandra H. Bettis, Richard T. Liu, Jama Pediatrics, October 21, 2019 Depression in adolescence is highly prevalent and associated with negative long-term outcomes.1 Despite decades of research on treatment for adolescent depression, sexual minority youths remain a particularly at-risk group.2 Temporal trends inform progress in addressing the need to eliminate health disparities among sexual minority populations.3 To our knowledge, this study presents the first population-representative...
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Preventable trauma in childhood costs north America and Europe US$ 1.3 trillion a year [WHO]

Karen Clemmer ·
By World Health Organization (photo by WHO/Malin Bring) The findings of a new study on the life-course health consequences and associated annual costs of adverse childhood experiences (ACEs) show that preventable trauma in childhood costs north America and the European Region US$ 1.3 trillion a year. The article, published in the Lancet and co-authored by Dinesh Sethi and Jonathon Passmore, Programme Manager, Violence and Injury Prevention, WHO/Europe, looks at the legacy of ACEs and their...
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Sheltering in Place: ACEs-Informed Tips for Self-Care During a Pandemic

Jim Hickman ·
Millions of lives have been affected in unprecedented ways by the Coronavirus (COVID-19). We are all grappling with uncertainty—our daily routines interrupted, not knowing what is to come. For those of us who have Adverse Childhood Experiences (ACEs), these times can be particularly distressing. At the Center for Youth Wellness (CYW), we know that childhood trauma can have a significant impact on an individual’s health and well-being – both physiologically and psychologically. Since the...
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Study: Stress Disorders Linked to Greater Infection Risk [mercurynews.com]

By Lisa Rapaport, Reuters, October 31, 2019 People who have stress disorders like PTSD may be more vulnerable to potentially life-threatening infections, especially if they are diagnosed at younger ages or dealing with other psychiatric issues, a recent study suggests. Researchers examined data on 144,919 people diagnosed with post-traumatic stress disorder (PTSD), adjustment disorders common after a major life change like a death or move, and other stress-related conditions. They also...
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The Center for Youth Wellness Launches Childhood Adversity Screening Program with Leading North Carolina Health Systems [PR Newswire]

Jim Hickman ·
Charlotte pilot program with Atrium Health and Novant Health supports state's goal to address social, economic and environmental health to improve child and family health outcomes The Center for Youth Wellness (CYW) announced it is partnering with two leading U.S. health systems in the Southeast to launch a screening program on childhood adversity. CYW's National Pediatric Practice Community (NPPC) has done on-site training at the headquarters of Atrium Health and Novant Health in Charlotte,...
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TIC: News and Notes for the Week of October 21, 2019 [dhs.wisconsin.gov]

Scott A Webb ·
ACEs, Adversity's Impact There is only one boat: The myth of normalcy by Dr. Gabor Mate Understanding historical trauma to strengthen community Childhood trauma linked to early, premarital childbirth and poor health for women Early life racial discrimination linked to depression, accelerated aging When mothers are killed by their partners, children often become 'forgotten' victims. It's time they were given a voice Children's language skills may be harmed by social hardship Does racism...
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Tools and how to use them is focus of second webinar on Community Resiliency Model, May 14, 2020

Carey Sipp ·
The second of two free Community Resiliency (CRM) webinars with Elaine Miller-Karas , key creator of the CRM, will be held Thursday, May 14, from 11 a.m. - 12:30 p.m. ET, (10 a.m. CT; 9 a.m. MT, and 8 a.m. PT) and will include the practical application of tools of the model. CRM is an ACEs science-based biological model for helping individuals become emotionally regulated during natural disasters and other dysregulating times. Miller-Karas will be joined by CRM trainers from Wilmington, NC:...
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University of Florida Graduate Public Health Course: Trauma-Informed Approaches for Individuals, Communities, and Public Health: Student Project Summaries

Lindsey King ·
The University of Florida College of Public Health and Health Professions partnered with Peace4Tarpon under the Robert Wood Johnson Mobilizing Action for Resilient Communities (MARC) grant. Together they created 2 online graduate courses that focus on addressing ACEs and creating trauma-informed and resilience-based programs from a public health approach. Peace4Gainesville and Peace4 TheBigBend have also contributed to these courses. This post is intended to showcase some of the work of the...
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Webinar: Cultivating Our Best Selves in Response to COVID-19 | Tuesday, March 17 at Noon PDT

Elaine Miller Karas ·
How to use the skills of the Community Resiliency Model (CRM) for self and others to be the calm in the storm as we face the unknown. Free Webinar Tuesday, March 17 at Noon PDT Speakers: Elaine Miller-Karas, LCSW Linda Grabbe, PhD, FNP-BC, PMHNP-BC Zoom Webinar Registration Link: https://zoom.us/j/715837300 Additional ways to join are listed at the bottom of this post. About the webinar leaders: Elaine Miller-Karas is the Executive Director and co-founder of the Trauma Resource Institute and...
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12 Things I Wish My Doctor Understood About Childhood Trauma

Anna Runkle ·
It doesn’t happen that often anymore, but one place where I almost always get triggered with my Childhood PTSD symptoms is when I visit the doctor. I could never even put this into words before. But now that I’m mostly healed from my Childhood PTSD symptoms, I want to express what I wish my doctors – all the doctors of my life – had understood about the effects of Childhood trauma, about me. Note: This is one of my most personal posts ever. Unless you’re someone who really prefers text, I...
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7 Ways to Help a Child Deal with Traumatic Stress

Hilary Jacobs Hendel ·
Traumatic stress feels awful. Thankfully, there are small things we can all do to help relax a hyperaroused nervous system.
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Action needed today by trauma advocates to urge Congress to address mental health and trauma in current COVID-19 legislation

The follow is a message from Dan Press, Legal Advisor to the Campaign for Trauma-Informed Policy and Practice ), about the need to contact Congress regarding a COVID 19 funding bill being considered this weekend. He is urging ACEs science/trauma advocates and leaders to send emails to their U.S. Senators and Representatives immediately to address the mental health and trauma implications of this pandemic. All – I hate to bother you on a Sunday, but we urgently need you to contact Congress to...
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Aligning Systems for Health: 2019 Call for Proposals [rwjf.org]

By Robert Wood Johnson Foundation, November 1, 2019 Required Components Aligning Systems for Health will explore the degree to which health equity is impacted or results from current models of collaboration incorporating health care, public health, and social services. Gaps in health are large, persistent and increasing, and RWJF is committed to a system that meets people’s goals and needs and addresses these gaps that many populations face. Studies should include a focus on health equity by...
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Announcing Trauma and Resilience Competencies for Nursing Education

Kathleen Wheeler ·
The authors are pleased to announce the Trauma and Resilience Competencies for Nursing Education. These competencies serve as a guideline of minimal expectations and reflect essential knowledge, skills and behaviors for three levels of nursing education: 1) undergraduate, 2) graduate, and 3) psychiatric nurse practitioner programs. The Trauma and Resilience Competencies, developed in 2018 at the Egan School of Nursing and Health Studies at Fairfield University in Connecticut by an Expert...
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Association of Exposure to Civil Conflict With Maternal Resilience and Maternal and Child Health and Health System Performance in Afghanistan [jamanetwork.com]

By Nadia Akseer, Arjumand Rizvi, Zaid Bhatti, et al., JAMA Network Open, November 8, 2019 Key Points Question: Is conflict severity associated with the performance of health systems and population health outcomes in Afghanistan during the 2003 to 2018 reconstruction period? Findings: In this survey study of 64 815 women in Afghanistan, notable health and health system improvements were made despite increasing conflict after 2010. However, regions with greater conflict had lower gains in...
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Cancer as a survivor

Christine Cissy White ·
Many people use the phrase CPTSD to stand for PTSD from complex trauma. To me, C-PTSD means cancer and PTSD. I have cancer and I’m a trauma survivor. I’m a survivor with cancer but not yet a cancer survivor. Will I be a survivor squared?
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CenteringParenting Recognized as Innovative Pediatric Intervention in New Report from The Center for the Study of Social Policy [globenewswire.com]

By Vandana Devgan, Centering Healthcare Institute, November 15, 2019 Centering Healthcare Institute (CHI) is honored to share that its pediatric group care model CenteringParenting®, has been recognized by The Center for the Study of Social Policy (CSSP) as an innovative pediatric intervention in its latest study. "Fostering Social and Emotional Health: Common Threads to Transform Everyday Practice and System" , released as part of the Pediatrics Supporting Parents (PSP) initiative, shares...
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Despite Gains, the Emotional Lives of Children Often Forgotten by Our Medical System [centerforhealthjournalism.org]

By A.K. Whitney, Center for Health Journalism, November 11, 2019 I don’t remember the date, or even the time of year, though the medical records tell me it was 1977. I was 6. But I will always remember that day: the gloomy, wood-paneled exam room at Karolinska Institutet in Stockholm, the hard, high table I sat on, the doctor looming above me as he muttered about swan necks and hammers, though there were no birds or tools in sight. He didn’t bother making eye contact with me. I’m not sure he...
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Dissecting Racial Bias in an Algorithm Used to Manage the Health of Populations [science.sciencemag.org]

By Ziad Obermeyer, Brian Powers, Christine Vogeli, and Sendhil Mullainathan, Science, October 25, 2019 Racial bias in health algorithms The U.S. health care system uses commercial algorithms to guide health decisions. Obermeyer et al. find evidence of racial bias in one widely used algorithm, such that Black patients assigned the same level of risk by the algorithm are sicker than White patients (see the Perspective by Benjamin). The authors estimated that this racial bias reduces the number...
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Got time for a little brainstorming with ACEsConnection?

Jane Stevens ·
On Friday, March 20, 2020, you're invited to join me to talk about how we, as a community, can continue to guide and educate ourselves about to deal with the effects of the spread of Covid-19, and how to continue those efforts with people who don't yet know about ACEs science. And, given this last week, how we can provide more support to stay in the front of our brains instead of feeding our amygdala.
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Governor Cuomo’s Cancer Research Initiative Disappointing. No ACES included.

Peter Chiavetta ·
I attended the presentation of Governor Cuomo's Cancer Research Initiative at the Buffalo Science Museum October 22, 2019. Brad Hutton Deputy Health Commissioner State of NY presented. Erie County Health Commissioners in attendance. It had all the data on the 4 major cancers in the East Side of Buffalo, NY. https://www.health.ny.gov/diseases/cancer/cancer_research_initiative/docs/erie_presentation.pdf I'm all excited. Prepared with 2 dozen ACE handouts. Sat quietly for the 45 minute power...
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Healthy Spaces December 2019 Webinars

Aldina Hovde ·
Healthy Spaces: Promoting Healthy and Resilient Communities December 2019 Webinars Funding provided by the New Jersey Department of Children and Families The New Jersey Chapter, American Academy of Pediatrics (NJAAP) believes that all children deserve to feel safe and secure in their home, at school, and while at play. The Healthy Spaces program aims to address adverse childhood experiences (ACEs) through partnerships with pediatric/family healthcare teams, schools and communities.
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How Can a Doctor Stop from Burning Out in the Pandemic? (greatergood.berkeley.edu)

Over the din of the negative pressure machine, I shouted goodbye to my patient. I zipped my way out of one of the little plastic enclosures in our emergency department (ED). With disgust and a bit of fear, I carefully shed my gloves, gown, and face shield. Only my precious mask remained on my face. I thought, This is a whole new world, and I hate it . The problem is that I’m losing that deep feeling of connection with patients, which is such an important part of this work. A few weeks ago,...
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How do these pediatricians do ACEs screening? Early adopters tell all.

Laurie Udesky ·
Last week, three pediatricians — with a combined experience of 15 years integrating ACEs science into their practices — reflected on the urgency they felt several years ago that prompted them to begin screening patients for childhood adversity and resilience when there was practically no guidance at all. Along their journey , they accumulated a list of lessons learned for other pediatricians and family clinics to use. The three pediatricians participated in the ACEs Connection webinar,...
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Intimate Partner Violence Screening and Intervention: The American College of Preventive Medicine Position Statement (Abstract) [sciencedirect.com]

By Tanya M. Phares, Kevin Sherin, Suzanne Leonard Harrison, et al., American Journal of Preventive Medicine, December 2019 The purpose of this paper is to produce a position statement on intimate partner violence (IPV), a major sociomedical problem with recently updated evidence, systematic reviews, and U.S. Preventive Services Task Force guidelines. This position statement is a nonsystematic, rapid literature review on IPV incidence and prevalence, health consequences, diagnosis and...
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Mount Sinai Announces Center for Stress, Resilience and Personal Growth [newswise.com]

Newswise — (New York, NY – April 30, 2020 ) -- Mount Sinai Health System (MSHS), one of New York’s largest integrated health systems, announced today the launch of the Mount Sinai Center for Stress, Resilience and Personal Growth, a first-of-its-kind initiative in North America that is designed to address the psychosocial impact of COVID-19 on the mental health and lives of frontline health care providers at Mount Sinai and will serve as a model for institutions and communities around the...
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My son was hospitalized and now he has PTSD

Stephanie Kennelly ·
“Grant, do you remember when you were in the hospital?” “Yes… they came to take the blood and I turned into a werewolf.” Original Post It happened quickly. A year ago my three year old had a collarbone fracture, it became infected and within 24 hours the situation was emergent. A week long hospital stay, one month with a PICC line and two months on oral antibiotics. Finally, the labs finally came back normal. The X-Ray was clean. Gillette Children’s Hospital closed our case. But the healing...
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Nurturing relationships in childhood boost adult mental health, relationships

Christina Bethell ·
We're proud to announce major research that suggests that positive childhood experiences — such as supportive family interactions, caring relationships with friends, and connections in the community — are associated with reductions in chances of adult depression and poor mental health, and increases in the chances of having healthy relationships in adulthood. This association was true even among those with a history of adverse childhood experiences.
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Prioritizing Physician Mental Health as COVID-19 Marches On [jamanetwork.com]

By Jennifer Abbasi, JAMA Network, May 20, 2020 I n the spring of 2013, Eileen Barrett, MD, MPH, lost a colleague to suicide. The two worked at the Indian Health Service’s Gallup Indian Medical Center in New Mexico, where Barrett was the deputy chief of medicine. Even before the tragic event, she saw workers struggle under administrative burdens and hold themselves personally responsible for problems outside of their control. With her coworker’s death it became painfully clear that clinician...
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Commentary: Why so many black Americans are dying from COVID-19 and how to make health care equitable (sandiegouniontribune.com)

Evidence suggests that during the early phase of the coronavirus pandemic, blacks are suffering the greatest death rates compared to all other ethnic groups. Why? I can assure you that the coronavirus does not discriminate based upon skin color or ethnicity. Instead, it has a predilection for populations with the highest rates of chronic diseases, poor access to health care and too little information from trusted sources. For decades, the National Medical Association — which represents more...
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"Addiction begins with solving a problem, the problem of human pain, emotional pain"

Laurie Udesky ·
In his groundbreaking book , In the Realm of Hungry Ghosts: Close Encounters with Addiction , trauma and addiction expert Dr. Gabor Maté writes, “There are almost as many addictions as there are people.” ACEs Connection founder and publisher Jane Stevens read that quote as a springboard to asking Maté to define addiction and explain whether or not it is always rooted in adverse childhood experiences. Maté, along with filmmaker Michelle Esrick and Saturday Night Live star Darrell Hammond,...
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What Do We Do? What Do We Do Now?

Jane Stevens ·
People’s response to the great chasms of structural inequities glaringly laid bare by the COVID-19 pandemic have been further inflamed by the murder of George Floyd and deaths of other African Americans in recent weeks. The acute emergency of the pandemic has eased, but the violence inflicted on racial minorities and now those who are protesting the inequities in our society has compounded the outrage. Right after the pandemic began running riot across the US, I often heard people ask: When...
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NEW Trauma-informed Care Podcast (CME provided)

Megan Gerber MD MPH ·
Join us as we delve into the paradigm-shifting ethos of trauma-informed care with renowned expert Dr. Megan Gerber. Dr. Gerber is an Associate Professor of Medicine at Boston University School of Medicine and serves as Medical Director of Women’s Health for VA Boston where she directs the Women’s Health Fellowship. Dr. Gerber edited the textbook, “Trauma-informed Health Care Approaches: A Guide for Primary Care.” We discuss the framework for trauma-informed universal precautions, as well as bas
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A Better Normal Tuesday, June 30th at Noon PDT: Reinterpreting American Identity, a Community Discussion

Alison Cebulla ·
"I think that all of us, regardless of our racial or ethnic background, feel relieved that we no longer have to deal with the racism and the sexism associated with the system of slavery. But we treat the history of enslavement like we treat the genocidal colonization of indigenous people in North America, as if it was not that important, or worse, as if it never happened." —Angela Davis, "The Meaning of Freedom" Please join us for the ongoing community discussion of A Better Normal, our...
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CMS: NEW – Waivers & flexibilities for health care providers 6.25.20

Karen Clemmer ·
Click here for the CMS Corona Virus Waivers & Flexibilities. Coronavirus Waivers & Flexibilities In certain circumstances, the Secretary of the Department of Health and Human Services (HHS) using section 1135 of the Social Security Act (SSA) can temporarily modify or waive certain Medicare, Medicaid, CHIP, or HIPAA requirements, called 1135 waivers. There are different kinds of 1135 waivers, including Medicare blanket waivers. When there's an emergency, sections 1135 or 1812(f) of...
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Physician Burnout, Interrupted (NEJM)

Karen Clemmer ·
By Pamela Hartzband, M.D., a nd Jerome Groopman, M.D. June, 25, 2020, N Engl J Med 2020; 382:2485-2487 DOI: 10.1056/NEJMp2003149. Before the onset of the Covid-19 pandemic, each day seemed to bring another headline about the crisis of physician burnout. The issue had been simmering for years and was brought to a boil by mounting changes in the health care system, most prominently the widespread implementation of the electronic health record (EHR) and performance metrics. 1 Initially, the...
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Reimagining Healthcare as a Community Investment

Jennifer A Walsh ·
At this point, COVID-19 has been a part of our lives for nearly six months now. While the most recent current events are not unfamiliar social problems, this pandemic has provided us with a stronger lens with which to see many of the underlying inequities within our communities. This article, “The Moral Determinants of Health,” explores these inequities by illustrating the systemic imbalances within the field of medicine and the amount of resources we allocate to solving problems as opposed...
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Help Navigating the Road to Community Resiliency

Becky Haas ·
The first time I ever heard the words trauma-informed care and the Adverse Childhood Experiences (ACEs) study was in the summer of 2014. At the time, I was working for the local Police Department as the Director of a grant-funded Crime Reduction Project aimed at reducing drug-related and violent crime. Of the many program goals, one was to develop a rehabilitative corrections program for felony offenders with addictions in order to reduce recidivism. Though I’ve lived in this region for...
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Incidence of Stress Cardiomyopathy During the Coronavirus Disease 2019 Pandemic (JAMA)

Karen Clemmer ·
By : Ahmad Jabri, MD ; Ankur Kalra, MD ; Ashish Kumar, MBBS ; et al, July 9, 2020, JAMA. Question Is psychological, social, and economic stress associated with coronavirus disease 2019 (COVID-19) associated with the incidence of stress cardiomyopathy? See attached pdf - or [ Please click here to read more. ]
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Navigating Trauma in Your Personal Statement for Medical School (In-Training)

Karen Clemmer ·
By Britt D. K. Gratreak, July 21, 2020, University of Arizona College of Medicine - Tucson I applied to medical school twice. In retrospect, I was unsuccessful the first time for a few reasons: my timing was terrible, I had too much humility about my achievements, and I didn’t ask for enough opinions about my application from people who were rooting for me. My trauma was also too raw and recent to write in a way for strangers to understand. After taking a few years to focus on research, I...
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Structural Racism, Social Risk Factors, and Covid-19 — A Dangerous Convergence for Black Americans (NEJM)

Karen Clemmer ·
Perspective by Leonard E. Egede, M.D., and Rebekah J. Walker, Ph.D. July 22, 2020, DOI: 10.1056/NEJMp2023616 . *Author Affiliations: From the Division of General Internal Medicine, Department of Medicine, and the Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee. Current protests throughout the United States are highlighting the history of marginalization of and discrimination against Black Americans, including 250 years of slavery, 100 years of Jim Crow laws,...
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Baby courts: A proven approach to stop the multigenerational transmission of ACES in child welfare; new efforts to establish courts nationwide

Carey Sipp ·
The organization Zero To Three estimates that in the U.S., a child is taken into the child welfare system every six seconds. “Many of society’s most intractable problems can be traced back to childhood adversity. Being in the child welfare system increases the likelihood of more adversity and criminality. Baby court is a proven approach to healing the trauma of both child and parent, and breaking the cycle of maltreatment,” says Mimi Graham, Ed.D ., director of the Florida State University...
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Trauma informed pain treatment

bennet davis ·
A patient-centered approach to opioid tapers must account for the reality that many people who are given a prescription for an opioid to treat pain have significant mental health conditions—for which opioids act as a psychotropic agent. An opioid taper must therefore address psychological trauma, in particular.
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Does VP Candidate Kamala Harris know about ACEs?  You bet!

Nadine Burke Harris, California’s Surgeon General, has a lot in common with the vice presidential candidate Kamala Harris—Jamaican heritage, surname, home state—and a commitment to addressing ACEs and toxic stress. As reported in the New Yorker article by Paul Tough, “The Poverty Clinic,” Dr. Harris told Kamala Harris, then San Francisco district attorney, about ACEs in 2008 and in response, she offered to help. District Attorney Harris then introduced her to professor of child and...
Comment

Re: What’s behind burnout in trainee physicians (Contemporary Pediatrics)

Jeoffry Gordon ·
YES, BUT! Even to use the term "burnout" is to buy into the oppressive perspective of an immoral, exploitative medical system. The real issue is "moral anguish" of clinicians who must work in an industrial environment where productivity and efficiency and an oppressive constraining electronic medical record trump attention, caring and compassion. Traditionally in medicine trainees (residents) learn best by being pushed, stressed, and dominated by the learned superiors (Germanic model). Now,...
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Public Health considers itself as a social science. It can be a resource for ACEs activists.

Dennis Haffron ·
I have just attended two Virtual meetings about public health. Public health agencies have been under funded for years. The covid19 crisis has impacted those institutions heavily. However many Public Health agencies are ACEs aware. They can be useful allies for ACEs activities. What follows is from the Fighting For Our Lives forums follow up communication. The recordings from the forum series are available at the following links. There is a brief registration form before you can view the...
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Psychological Trauma Is the Next Crisis for Coronavirus Health Workers [Scientific American]

Jennifer A Walsh ·
After his roughest days in a New York City emergency room, physician Matthew Bai feels his whole body relax when he sees his wife and 17-month-old daughter. “My light at the end of the tunnel is going home to family,” Bai says. When Manhattan’s Mount Sinai Hospital started to overflow with COVID-19 patients in late March, however, Bai and his wife decided she should take their toddler and stay with her parents in New Jersey. The risk of spreading the virus to his family was too great. Now...
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New ACEs initiatives learn about strategic plan development from from New Hanover (NC) Resiliency Task Force executive director Mebane Boyd

Carey Sipp ·
The desire to see other ACEs initiatives grow and flourish was evident at a recent meeting of the Resilient Columbus County (North Carolina) ACEs initiative when Mebane Boyd, executive director of the New Hanover Resiliency Task Force (also in North Carolina), shared with the Columbus County and neighboring Pender County groups how New Hanover created and works on its strategic plan. In the spirit of sharing, Boyd agreed to let ACEs Connection post the strategic plan and the video of the...
 
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