Presentation on theme: "Addressing Trauma in Our Communities"— Presentation transcript:
1Addressing Trauma in Our Communities Matters of the Mind:Addressing Trauma in Our CommunitiesNancy C. Lee, M.D. Deputy Assistant Secretary for Health-Women’s Health Office on Women’s Health U.S. Department of Health and Human ServicesApril 22, 2013
2Functional Definition of Trauma Trauma occurs whenever an external threat overwhelms a person’s coping resources.
3What is Trauma? A Practical Definition Non-consensualVictim feels discomfort, fear, intimidatedBodily integrity, or that of someone else, is threatened
4Prevalence of Trauma in the U.S. Rape and Sexual Assault One out of 6 U.S. women has been the victim of an attempted or completed rape in her lifetime17.7 million U.S. women have been victims of attempted or completed rape.Source: RAINN
5Intimate Partner Violence 1 out of 3 women experience at least one physical assault by a partner.Men who have witnessed their parents' domestic violence are twice as likely to abuse their wives.Girls who have witnessed domestic violence are more likely to stay in an abusive relationship as an adult.More than 50% of batterers also abuse their children or their victim’s children.
6Prevalence of Trauma in the U.S. Childhood Sexual Abuse At least 2 of every 10 girls, and 1 of every 10 boys are sexually abused by the end of their 13th year.
7Prevalence of Trauma in the U.S. Very common that an individual will have exposure to multiple traumatic events during their lives
8Long Term Consequences Emotional Stress and Mental IllnessPhysical Illness, Disease and DisabilityHigh-Risk BehaviorsThe Impact of Trauma is Dramatically Underestimated
9The Adverse Childhood Experience (ACE) Study Study analyzing the relationship between multiple categories of childhood trauma (ACEs), and health and behaviors later in life among 17,000 adult patients.Collaboration between the CDC and Kaiser Permanente Health System.The Co-principal Investigators -Vincent J. Felitti, MD, Kaiser PermanenteRobert F. Anda, MD, CDCOver 17,000 Kaiser patients participated in routine health screening volunteered to participate in the study. Data continues to be collected and analyzed.Study reveals staggering proof of the health, social, and economic risks that result from childhood trauma.
10What is an ACE? Growing up experiencing any of the following conditions prior to age 18Physical abuseEmotional abuseSexual abusePhysical neglectAn alcohol or drug abuser in homeSomeone who is mentally ill or suicidal in homeMother is treated violentlyOne or no parents in homeAn incarcerated family member
11ACE Score Prevalence 0 33% 1 25% 2 15% 3 10% 4 6% 5+ 11%* %%%%%%**Women are 50% more likely to have a score >5.
12ACE Study FindingsAs the number of ACEs increase, the risk for health problems increase in a strong and graded fashion.
13ACE Study FindingsSuicide At least 2/3 of all attempted suicides can be attributed to adverse childhood experiences. Sexually Transmitted Diseases There is a 250% increased risk of having an STD between individuals with an ACE Score of 4 vs. an ACE Score of 0.
14ACE Study Findings An Individual with an ACE Score of 4 is: Chronic lung disease260% more likely than someone with an ACE Score of 0.Depression460% more likely to than someone with an ACE Score of 0.
15ACE Study Findings IV Drug Use The relationship of ACE to IV drug use is particularly striking.A man with an ACE score of 6+ has a 4600% increased risk of becoming an IV drug user.
16In Summary, the ACE Study indicates… ACEs are basic and long lasting determinants of: health risk behaviorsmental illnesssocial malfunctiondiseasedisabilitydeathhealthcare costs
17Secondary Victimization Also referred to as “Retraumatization” Victimization which occurs, not as a direct result of the traumatic event, but through the response of institutions and individuals to the victim
18Examples Dental settings Ob-Gyn The supine positionCan’t speakOb-GynPelvic examBreast examsSo what can be done to prevent Retraumatization?
19Trauma-informed Care Take the trauma into account Avoid triggering trauma reactionsAdjust the behavior of providers to support the individual’s coping capacityThis will allow survivors to access and benefit from servicesServices that are provided for issues other than trauma but require knowledge about the impact of trauma to improve effectivenessEvery part of an agency or institution from front desk staff, administrators, to care providers:Understand the effects of exposure to traumatic eventsSensitively interact with trauma survivorsPrevent re-traumatizingEngage in trauma screening as appropriate
20Trauma-Informed Care Paradigm shift from… What’s wrong with you? to What happened to you?
21Keep in MindYou are likely to encounter survivors of trauma who do not discloseNot all survivors are psychologically ready to discuss their experiences
22Summary Traumatic events are prevalent in our society Trauma has negative physical, psychological and behavioral consequencesSurvivors may experience “secondary victimization” when they seek helpYou can help reduce some of these problems through trauma-informed practices
23Substance Abuse Mental Health Services Administration (SAMHSA) SAMHSA's National Center for Trauma- Informed Care provides technical assistance to build awareness and promote implementation of trauma-informed practices.
24Webinar Series provided by the Office on Women’s Health, in partnership with SAMHSATo Register for our upcoming webinars:https://services.choruscall.com/links/womenshealth.html