November 29, 2011

New Mental Health Research

Yesterday we held our bi-monthly meeting of Women’s Alliance members (nonprofit organizations that work with girls and women – this includes grantees and non-grantees) and heard a presentation from Laura Healless, LISW, MSW, who is the social worker involved in our DASH Pilot Project. 

Laura’s work is based on research including the Adverse Childhood Experiences (ACE) Study, a study conducted at Kaiser Permanente (1995-97) involving over 17,000 participants.  Each participant had a standard physical examination and completed a confidential survey about their childhood (through age 18), particularly related to experiences and family dysfunction.  Attached is a copy of this simple survey.

Participants were then tracked according to health status and behaviors, and the groundbreaking results proved a direct correlation between traumatic (“adverse”) childhood experiences and a multitude of health and social problems throughout a lifetime.  And the severity and extent of health problems increases according to an increase in these adverse experiences.  The documented health problems noted included:

×          Adolescent pregnancy
×          Alcoholism and alcohol abuse
×          Anxiety
×          Chronic pain
×          Chronic obstructive pulmonary disease (COPD)
×          Depression
×          Diabetes
×          Early death
×          Early initiation of sexual activity
×          Early initiation of smoking
×          Fetal death
×          Hallucinations
×          Health-related quality of life
×          Hypertension
×          Illicit drug use
×          Ischemic heart disease (IHD)
×          Liver disease
×          Lung cancer
×          Memory disturbances
×          Multiple sexual partners
×          Risk for intimate partner violence
×          Sexual abuse
×          Sexually transmitted diseases (STDs)
×          Smoking
×          Suicide attempts
×          Unintended pregnancies
×          Violence

Resulting from the ACE Study, the medical community is now being trained in both ACE and what is termed “Trauma-Informed Care,” meaning that clinicians are looking further into the social history of patients to uncover the factors that may have influenced the diseases and behaviors they are diagnosing.  By identifying and discussing these experiences, patients can then learn to model a healthier lifestyle – that they do not need to continue in a pattern set in childhood.  The medical and public health community is adopting this key understanding, including major funders such as the Gates Foundation’s Global Health Program.

If you’re interested, here are definitions of Adverse Childhood Experiences from the clinicians involved in the study:  

Adverse Childhood Experiences Definitions
The following categories all occurred in the participant's first 18 years of life.
Emotional Abuse
Often or very often a parent or other adult in the household swore at you, insulted you, or put you down and sometimes, often or very often acted in a way that made you think that you might be physically hurt.
Physical AbuseSometimes, often, or very often pushed, grabbed, slapped, or had something thrown at you or ever hit you so hard that you had marks or were injured.
Sexual Abuse
An adult or person at least 5 years older ever touched or fondled you in a sexual way, or had you touch their body in a sexual way, or attempted oral, anal, or vaginal intercourse with you or actually had oral, anal, or vaginal intercourse with you.

Emotional Neglect
Respondents were asked whether their family made them feel special, loved, and if their family was a source of strength, support, and protection.  Emotional neglect was defined using scale scores that represent moderate to extreme exposure.
Physical Neglect
Respondents were asked whether there was enough to eat, if their parents drinking interfered with their care, if they ever wore dirty clothes, and if there was someone to take them to the doctor.  Physical neglect was defined using scale scores that represent moderate to extreme exposure.
Mother Treated Violently
Your mother or stepmother was sometimes, often, or very often pushed, grabbed, slapped, or had something thrown at her and/or sometimes often, or very often kicked, bitten, hit with a fist, or hit with something hard, or ever repeatedly hit over at least a few minutes or ever threatened or hurt by a knife or gun.
Household Substance Abuse

Lived with anyone who was a problem drinker or alcoholic or lived with anyone who used street drugs.
Household Mental Illness
A household member was depressed or mentally ill or a household member attempted suicide.
Parental Separation or DivorceParents were ever separated or divorced.
Incarcerated Household Member
A household member went to prison.

For Chrysalis, our role is to share this information and to teach it in our educational programs for grantees, other nonprofits, and Chrysalis After-School program staff – all in our continued efforts to strengthen and support girls and women.