1. Trauma and Trauma Informed Care

2. Trauma  What is trauma?  How prevalent is trauma ?  How long does it last?  Why should we be aware of it?

3. Most Important Health Research of the Decade  Kaiser Permanente and U.S. Centers for Prevention and Disease Control (CDC)  Correlated early life trauma to current health status.  Asked ten questions about adverse childhood events

4. What percentage of people had Childhood trauma?  Abuse  1. emotional – recurrent threats, humiliation (11%)  2. physical - beating, not spanking (28%)  3. contact sexual abuse (28% women, 16% men; 22% overall)  Household dysfunction  1. mother treated violently (13%)  2. household member was alcoholic or drug user (27%)  3. household member was imprisoned (6%)  4. household member was chronically depressed, suicidal, mentally ill, or in psychiatric hospital (17%)  5. not raised by both biological parents (23%)

5. What percentage of people had Childhood trauma?  Neglect  1. physical (10%)  2. emotional (15%)

6. Nevada County  65-70% of Nevada County residents have at least an ACE score of one  One in six have an ACE score of 4 or more

14. ACE score relationship to the leading causes of death  The higher the ACE score the higher likelihood of:  Heart disease  Any cancer  Stroke  diabetes

15. ACE score relationship to the leading causes of death  Emphysema  Skeletal fractures  Hepatitis / jaundice  Premature births  Obesity  Smoking  Alcoholism

16. ACE score of four or more  21% more likely to live in poverty  39% more likely to be unemployed  22% more likely not to have a personal doctor

17. ACE Study conclusions  The greatest public health threat is child abuse  The effects of adverse childhood experiences are profound and enduring  ACE study does not take into account trauma occurring as an adult.

18. Trauma Informed Care  Hidden silent epidemic  Survivors have shame, suffer silently  How can we best serve this population?

19. Trauma Informed Care  Kaiser study in decreasing emergency room visits for high ACE score clients  Sensitively asking and educating.

20. Post Traumatic Stress Disorder  Exposure to a traumatic event, response involved intense fear, helplessness or horror.  Intrusive thoughts, feelings  Avoidance, numbness, feelings of detachment  Increased arousal  Effects mood, sense of foreshortened future

21. Trauma Triggers cause relapse or a fall back into a former state  Substance Abuse: sounds, smells, sights, feelings, etc. trigger cravings  Mental Health: Triggering events that brings about a symptom of PTSD

22. Trauma Informed Institution  Examine our physical layouts  Examine our data processes  Examine staff knowledge of what trauma looks like.

23. Trauma Triggers  Powerlessness,  Trapped, something bigger is controlling  Antidote: Give voice and choice  Acknowledge the past pain

24.  Rebecca Slade  530-470-2784  Rebecca.slade@co.nevada.ca.us