We've been counting the bodies wrong - 2

From a book 'Greater Than Gravity' by Michael J Menard

Part 1 of this blog is here.

Buried beneath the weight of society’s progress lies a silent epidemic: the profound and lasting impact of childhood trauma - a force that not only shatters individual lives but threatens the foundation of our communities.

Michael Menard continues:

As we continue with the topic of childhood trauma, we need to recognise that our society, sadly and surprisingly, is still in the budding stages of understanding and addressing this epidemic. We can draw a parallel to the fight against infectious diseases around the 1900's - we are at the first phase - the hand-washing stage - recognising that hygiene was a foundational practice in preventing illness. Today, we need to recognise that raising awareness and initiating conversations around childhood trauma is a necessary, albeit insufficient, starting point. [WOTS - I would argue this especially applies to parents].

We have yet to implement comprehensive and effective strategies that genuinely disrupt the cycle of childhood trauma. We do not have a shared understanding of childhood trauma and the pervasive nature of its associated problems. There is a pressing need for more robust interventions, proactive prevention measures and systemic changes in how we  approach and understand childhood trauma.

Michael suggests 3 areas of effort required to end childhood trauma; Awareness, Healing Interventions and Prevention.

1. Awareness

In his search for top issues facing humanity, Michael discovered that poverty, war, obesity, drug abuse and racism dominate, while the profound impact of childhood trauma remains curiously absent. Despite research showing that the long-term effects of childhood trauma exceed those of cancer, heart disease, diabetes and stroke combined, it fails to secure a place in national or global discourse. How can this be?

Increased awareness could lead to transformative changes in how we address not only individual mental health struggles but also societal wellbeing. Health care providers often overlook the signs of trauma in their patients, educators remain uninformed about the profound effects of adverse childhood experiences on learning and behaviour and communities as a whole do not recognise the deep-seated roots of dysfunction and violence that can stem from unresolved childhood trauma.

[WOTS - My own research in 2023 showed that 50% of 18-50 year old parent respondents had no or little knowledge of ACEs and 76% no, little or moderate knowledge. 52% would change their parenting approach a lot or great deal if they had more information about ACEs and 78% a lot, great deal, moderate amount. (+-7% confidence level). This demonstrates there is great scope here for community awareness actions.]

2. Healing Interventions

Focusing in on the mental health aspects, (the top conditions that increase with more ACEs are anxiety and depression), a study by the US National Institute of Mental Heath found that 2/3rds of individuals suffering from depression seek treatment and yet a study of these over a decade revealed that 90% reported ongoing symptoms. They face a chronic, episodic struggle.

The treatments often do not target the underlying causes, instead they focus on symptom management. Patients who do not achieve improvement often internalise failure, while professionals grapple with treatment outcomes for their reputations. To truly heal and prevent future episodes, we need therapists and health practitioners to fully grasp the impact of ACEs and focus on finding the root causes and interventions that can affect real change.

[WOTS - “135,000 adults going through a US Health Appraisal with ACE screening with follow-up produced a 35% reduction in GP visits and an 11% reduction in Emergency Department visits over the following year compared with that group’s prior year utilization. We realized that asking with later follow up, coupled with listening and implicitly accepting the person who had just shared his or her dark secrets, is a powerful form of doing."Health Appraisal and the Adverse Childhood Experiences Study 2019 ]

3. Prevention

Society's approach to ACEs often reacts to trauma rather than address its root causes, leaving the most vulnerable populations to navigate silos and inadequate support systems. These systems are often punitive e.g. exclusion of a child from school rather than addressing the underlying issues that lead to trauma. There are two aspects here; personal or family issues, and broader societal systemic and cultural factors where prevention is not seen as a collective responsibility. We need to address both.

We should all be asking, "Why have we failed to make significant strides in preventing childhood trauma despite the wealth of knowledge we possess about its prevalence and widespread destruction?"

Michael suggests several prevention strategies:

1. Support and protect the parent/infant bond in the first 60 days after birth.
2. Family-centred programmes to support the parents along with parenting classes.
3. Building community connections that foster child activities and belonging.
4. School-based mental health professionals to recognise early signs of trauma.
5. Prioritise child welfare and trauma prevention in all policies.
6. Trauma-informed practices in state actors
7. Promoting resilience so that children can cope with adversities.

[WOTS - In my own research, these are some summary suggestions, (in-depth details are given in the research), arranged into Michael's three areas of effort required to end childhood trauma:

1. Awareness

• Raise awareness: All new and expectant parents should be informed about ACEs and their effects. Despite the availability of information, parents are not made aware of ACEs by health professionals.
• Education: Run a neurodevelopment and ACEs curriculum in all secondary schools i.e. future parents.
• Show the documentary ‘Resilience’ on a major TV channel frequently.
• Hold a mandatory parents’ assembly at primary schools on ACEs.

2. Healing Interventions

• Trauma-informed practices: State agencies should continue to adopt approaches that focus on understanding and mitigating the effects of trauma.
• Screening: Introduce mandatory ACE screening for children and adults at GP level, or at least for those presenting with certain conditions e.g. anxiety, depression, ADHD, PTSD, autism, chronic fatigue. 
• Self-help groups: Support groups for ACE survivors can reduce mental health disorders.
• Support for at-risk children: Increase attachment to independent adults through mentoring programmes.
• Social prescribing: Encourage volunteering and prosocial behaviour as protective factors.

3. Prevention

• Behavioural nudges re positive parenting: Use behavioural science to promote the benefits of and encourage positive parenting.
• Parenting courses: Offer free, evidence-based online parenting courses to all new and expectant parents.
• Community initiatives: Replicate successful US community resilience programmes in the UK.
• Stable relationships: Use behavioural science to incentivise family stability and support communication and kindness within families.
• Data-driven interventions: Collect and publish local ACE indices to target interventions and resources where they are most needed.
• Shift focus from mitigation to prevention: A fundamental change in public service systems, which currently focus on dealing with the effects of ACEs at great cost. Prevention, especially through parental and community engagement, is more cost-effective and beneficial for society.
• Disrupt systemic barriers: There is a resistance to moving to prevention due to budget silos and vested interests in the current system. There should be cross-sector collaboration and a shared goal of creating a trauma-free society, rather than a trauma-informed one. This forces the focus onto prevention.]