PHC6534: Prevention of Anxiety, Depression, and Suicidal Thought and Behaviors in College Students affected by Adverse Childhood Experiences (ACEs)

In my grant proposal, a multi-level trauma based intervention program will be proposed to address the prevention and treatment of mental health problems among college students attending the University of Florida, in Alachua County who experienced at least one ACE. (SAMHSA, 2021)

Trauma-Informed Principles Your Grant Will Utilize

Four out of the six Trauma-Informed Principles will be built into the program to provide prevention and treatment services. (Feuer-Edwards, et al., 2016) This first principle is safety. (Feuer-Edwards, et al., 2016)  The program environment will promote a sense of safety, calming, and de-escalation for participants and staff. A trauma informed design will be utilized when creating the physical space for the project. (SAMHSA, 2021) It will create spaces that are welcoming and safe, respects the individual's privacy, identity, dignity, and promotes empowerment. (SAMHSA, 2021) They will also address aspects of the physical environment that may be retraumatizing and develop strategies to deal with it. The second principle is trustworthiness and transparency. (Feuer-Edwards, et al., 2016) The program staff will build trust with the participants by listening to their concerns. They will ensure that operations and decisions in the program are conducted with transparency. The third principle is peer support and mutual self-help. (Feuer-Edwards, et al., 2016) The program will recognize the value of peer support for establishing safety and hope, building support, and utilizing their stories and lived experiences to promote recovery and healing. Through the cognitive behavioral therapy provided in the program, the UF students will be able to interact and share similar experiences with others who have undergone at least one ACE. This can help the students grow and build their self esteem. The last principle is cultural, historical and gender issues. (Feuer-Edwards, et al., 2016) The program staff will be trained to be culturally sensitive and acknowledge bias in regards to race/ethnicity, religion, sexual orientation, and  recognize and address historical trauma to the prevention and treatment services that will be provided. It also responds to the ethnic and cultural needs of the participants being served. (Feuer-Edwards, et al., 2016)

Level(s) of Social Ecological Model

For this program, I will use the CDC Socio-Ecological Model as a framework to highlight how factors overlap to create mental health issues in students. (CDC, 2022) It will address the individual, relationship, and community level. These levels were chosen because they illustrate how factors at the individual level (beliefs, history of abuse, education) overlap with factors at the relationship level (relationship with peers and family) and factors at community level (neighborhood poverty and instability) interact to put students at risk for experiencing ACEs and mental health problems. In order to address those issues, it is important to work across all those levels. At the individual level, the students will be screened for their attitudes, culture, and history of trauma. Students will recognize how biological and personal history factors can increase their chance of experiencing at least one ACE through screening tests. At the relationship level, we will address the relationships with their families, friends, peers, significant others, and support systems that have a positive or negative effect on their behaviors and contribute to their experience. This will be analyzed through the CBT and the AC&T therapy. Lastly, at the community level, the program staff will be investigating the students' environment, social support networks, neighborhoods, workplace, and school settings. They will address conditions (ex. drug and alcohol outlets) that give rise to trauma and negative mental health status. (CDC, 2021) They will create a safe space for the students participating in the project.

Public Health Framework

This program will utilize the public health framework to provide trauma informed preventive and treatment services to UF students who have experienced one or more adverse childhood experiences. The program aligns with primary, secondary, and tertiary prevention levels of the public health framework. (Heard et al., 2017)The primary prevention phase will address the mental health concerns of UF students who have experienced one or more ACES in their lives.  (Heard et al., 2017)This will occur by bringing awareness of ACE’s and mental health to the targeted population through social media campaigns and tabling on campus. For the secondary prevention phase, a licensed health professional on the team will conduct a universal screening for trauma, depression, anxiety, and suicidal risk.  (Heard et al., 2017) Patient Health Questionnaire (PHQ-9), Beck Anxiety Inventory, Columbia Suicide Severity Risk Scale (C-SSRS) are the screening scales that will be used for screenings. (RHIhub, 2022) Lastly, for tertiary prevention, trauma informed therapy and treatment will be provided. (Heard et al., 2017) This will improve students mental health by reducing the severity of symptoms associated with anxiety and depression, decreasing suicide risk, and increasing the access to mental health services. Being able to use the public health framework will allow public health professionals to have a greater impact than the medical model. (Feuer-Edwards, et al., 2016) In order to address mental health issues among UF students who have experienced at least one ACE, a multi-pronged holistic approach is necessary. (SAMHSA, 2021)

Citations:

1. CDC. (2022, January 18). The social-ecological model: A framework for prevention |violence prevention|injury Center|CDC. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/violencepr...ecologicalmodel.html
2. Feuer-Edwards,, A., O’Brien, C., & O’Connor, S. (2016, October). Trauma-Informed Philanthropy: A Funder’s Resource Guide for Supporting Trauma-Informed Practice in the Delaware Valley. Philadelphia; Grantmakers of Western Pennsylvania.
3. Funding for Good Inc. (2019, August 1). Sustainability plan - sample verbiage. Funding for Good. Retrieved from https://fundingforgood.org/pro...lan-sample-verbiage/
4. Heard, E., Mutch, A., & Fitzgerald, L. (2017). Using applied theater in primary, secondary, and tertiary prevention of intimate partner violence: A systematic review. Trauma, Violence, & Abuse, 21(1), 138–156. https://doi.org/10.1177/1524838017750157
5. RHIhub. (2022). Screening for and addressing suicide risk in clinical settings - RHIHUB toolkit. Screening for and Addressing Suicide Risk in Clinical Settings - RHIhub Toolkit. Retrieved from https://www.ruralhealthinfo.or...de/2/screening-tools
6. Substance Abuse and Mental Health Services Administration (SAMHSA): Prevention and Treatment of Anxiety, Depression, and Suicidal Thoughts and Behaviors Among College Students. SAMHSA Publication No. PEP21-06-05-002. Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration, 2021.