Health Solutions For Families Affected By Abuse and Other Trauma

Shaquita Ogletree
The National Health Collaborative on Violence and Abuse (NHCVA) and Futures Without Violence sponsored a briefing last month, Health Solutions to Women, Children, and Families Affected by Trauma and Abuse.

The panel included the First Lady of Massachusetts, Lauren Baker, Sabrina Matoff-Stepp, Office of Women’s Health, HHS, Tiffany Flowers, Pathways Counseling Center, Iowa, Karen Clemmer, and ACEs Connection in California, Kiersten Stewart, Futures Without Violence, and Jeanette Scheid, the National Health Collaborative on Violence Abuse. The panel explored the short and long-term health impacts of violence and the need to raise awareness of childhood trauma.

According to the Center on Disease Control and Prevention (CDC), 1 in 5 women have been raped in their lifetime, and 1 in 4 women have been the victim of severe physical violence by a partner. Eighty percent of victims experienced significant short-term and long-term impacts including PTSD and long-term chronic diseases. In addition, sixty percent of U.S. children have been exposed to violence or abuse. Children exposed to violence are more likely to exhibit behavioral and physical health problems such as depression, suicidal tendencies, and drug and alcohol abuse.

In her remarks, First Lady Lauren Baker, said that she experienced a significant realization when she recognized that trauma- informed principles should be applied to most people not just individuals with mental health. In Massachusetts, there has been some progress in women’s services and education including the development of a Trauma Taskforce. The Governor has been committed to creating a culture change, especially for patients with severe mental illness. As part of the overall changes in that state, the Department of Correction has demonstrated significant progress. As an example, the Bridgewater State Hospital has experienced a decrease of 91 percent in the seclusion of patients and a decrease of 99 percent in restraints. Baker said that this trauma-informed care collaboration with organizations and the state is promising.

Ms. Clemmer said that research proves that evidence-based programs like Home Visiting is a two-generation approach. The most significant return on investment is prenatal care when supporting individuals with high adverse childhood experiences (ACEs). According to the CDC prevention survey, 1 in 4 women and 1 in 7 men will experience intimate partner violence (IPV) resulting in shame, fear, trauma, and stigma. Responding to IPV should be integrated into programs and policies.

The Health Resources and Service Administration (HRSA) strategy to address IPV is to integrate increased access to training. HRSA collaborated on a pilot to integrate screening and counseling for IPV. As a result of the pilot, state leadership teams will use a collaborative learning model for the Project Catalyst initiative at the state and policy level.

Tiffany Flowers discussed the Pathways Counseling Center in Cedar Rapids. The state collaborated with the health care providers and a domestic violence agency for cross-system training and integration of trauma-informed services. The relationship between IPV and substance use are more prevalent in women, and more attention in health settings is needed. Kiersten Stewart discussed how more than one-third of American children under the age of 17 has been physically assaulted, and about 18 million have witnessed a parent physically assault another.

Resources that were highlighted during the discussion included:

● The Violence Against Women Act (VAWA) includes programs that train health care providers and strengths collaborations between public health and domestic violence agencies.
● The Department of Justice’s Children Exposed to Violence Initiative that provides early investment for children who witness or experience violence in their homes, schools, or communities.
● HRSA’s Project Catalyst Initiative that support state level policy and systems change and collaborations in community health centers and domestic violence advocacy programs.
● Trauma-Informed Care for Children and Families Act (S.774/HR 1757) legislation included in the Opioid bill would help communities identify and disseminate best practices and trainings, improve treatment capacity, and community coordination to help children experiencing trauma.

For more information about how HRSA is helping women and girls, visit their website www.hrsa.gov