9/5/2015 Impact of Childhood Trauma on Health Allison Jackson, Ph.D., LCSW Trauma Informed Care Operations Manager Richmond Department of Social Services Healthy Living/Health Services Subcommittee September 9, 2015 2 1
9/5/2015 3 Brains Impacted by Lived Experience 4 2
9/5/2015 POPULATION ATTRIBUTABLE RISK A large portion of many health, safety and prosperity conditions is attributable to Adverse Childhood Experience. ACE reduction reliably predicts a decrease in all of these conditions simultaneously. 5 ACEs INFLUENCE VIA BIOLOGIC IMPACT ON NEURODEVELOPMENT INDIVIDUAL OUTCOME BRAIN •Edgy Individual & Hormones, chemicals & •Hot temper species survive cellular systems prepare •Impulsive the worst for a tough life in an evil •Hyper vigilant conditions. • “ Brawn over world brains ” TRAUMATIC STRESS NEUTRAL START INDIVIDUAL OUTCOME •Laid back BRAIN Individual & •Relationship ‐ Hormones, chemicals & species live oriented cellular systems prepare peacefully in •Thinks things for life in a benevolent good times; through world vulnerable in • “ Process over poor conditions power ” 6 3
9/5/2015 SOLUTIONS ACROSS THE CONTINUUM 7 Add CDC’s ACE optional module to Virginia’s Health Indicator Data Behavioral Risk Factor Surveillance System (BRFSS) 8 4
9/5/2015 HIGH CAPACITY COMMUNITIES REDUCE PERCENT OF YOUNG ADULTS WITH ≥ 3 ACEs POSITIVE ACE TREND MEANS 37.9% REDUCED CASES: 38.4% 33.8% 35.2% Lack of Social 1888 Support 29.6% 31.8% Limited Activity (due 5767 to disability) 25.9% Asthma 2128 Cancer 2828 23.6% Heart Disease 1004 15.1% Missed work due to 1065 MI Youngest Mental Illness (MI) 3845 Age Cohort HIV 1264 9.8% Binge Drinking 3727 65+ 55-64 45-54 35-44 18-34 Smoking 10874 In Crisis & Persistent Thriving Low capacity High capacity (n=1,537,995) (n=1,255,900) ACE REDUCTION IS A WINNABLE ISSUE 9 Early Screening and Intervention in Schools and Primary Care • Reaching youth and families on the early end of the continuum provides better quality of life and lowers healthcare costs Schools – Cognitive Behavioral Intervention for Trauma in Schools (screening and 10 week group, parent involvement, teacher involvement) Primary Care ‐ Pediatric Symptom Checklist completed by parents to assess child functioning 10 5
9/5/2015 TennCare Focus FOCUS AREA: Assuring that youth who could be treated in the community for behavioral health needs had access to high quality behavioral health services in the community • Improve behavioral health of youth served • Reduce reimbursement rates across the state 11 TennCare Project • Determine youth who could be served in – Home Based Treatment (HBT) – Mental Health Care Coordination Instead of RTC placement • Work with MCOs to define terms, policies, and reimbursement rates • Put out RFP to behavioral health providers to participate 12 6
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