# Presentation: 296754

## Dare to Act: Trauma Survivors, Practitioners, Researchers, and Policymakers Creating a Blueprint for ChangeDecember 1, 2004Baltimore, MD

**A. Kathryn Power, M.Ed., Director **
**Center for Mental Health Services**

## Meeting Objectives

- Identify how to support trauma-informed knowledge applications.
- Promote the use of trauma-informed programs, policies, and practices.
- Mobilize a broad-based and effective trauma-informed learning community.

## “You gain strength, courage, and confidence by every experience in which you stop to look fear in the face. You are able to say to yourself, ‘I lived through this horror. I can take the next thing that comes along.’”

Eleanor Roosevelt
You Learn by Living (1960)

- Eleanor Roosevelt
*You Learn by Living* (1960)

## Childhood Trauma and Mental and Substance Use Disorders

- Up to two-thirds of both women and men in substance abuse treatment programs report childhood abuse or neglect.
- Nearly 90 percent of women who are homeless and who also have a mental illness experienced severe abuse as both children and as adults.
- Between 30 and 60 percent of women who abuse substances meet the criteria for post-traumatic stress syndrome.  Most often, their syndrome is rooted in a history of repetitive childhood abuse.

## Health Outcomes of Violence Against Women 

**Partner Abuse**
**Sexual Assault**
**Child Sexual Abuse**

**Fatal **
**Outcomes**

**Nonfatal Outcomes**

- Homicide
- Suicide
- Maternal mortality
- AIDS-related

**Physical Health**
- Injury
- Functional impairment
- Physical symptoms
- Poor subjective health
- Permanent disability
- Severe obesity

**Chronic Conditions**
- Chronic pain syndromes
- Irritable bowel syndrome
- Gastrointestinal disorders
- Somatic complaints
- Fibromyalgia

**Mental Health**
- Post-traumatic stress
- Depression
- Anxiety
- Phobias/panic disorder
- Eating disorders
- Sexual dysfunction
- Low self-esteem
- Substance abuse

**Negative Health**
**Behaviors**
- Smoking
- Alcohol and drug abuse
- Sexual risk-taking
- Physical inactivity
- Overeating

**Reproductive Health**
- Unwanted pregnancy
- STDs/HIV
- Gynecological disorders
- Unsafe abortion
- Pregnancy complications Miscarriages/low birth weight
- Pelvic inflammatory diseases

**Source:** Center for Health and
- Gender Equity (CHANGE)

## Extent of Childhood Abuse

- Childhood abuse affects one in five girls and one in seven boys before they reach age 18.
- A child is reported to be abused or neglected every 10 seconds.
- Every 2 hours, a child is a homicide victim.

- Eighty-one million children younger than age 19 are now growing up in the United States.

## Economic Costs of Trauma:  We All Pay the Price

- Our States spend at least $20 billion on child welfare services every year.
- Intimate partner rape, physical assault, and stalking of women cost our Nation more than $4 billion a year.
- This sum includes only *direct* medical and mental health care services.  It does not include lost productivity, criminal justice services, or the immeasurable personal toll.

## Blueprint for Change

- Actions to expand trauma-informed community-based services.
- Actions with the potential to transform the environments in which trauma can occur and recovery must happen    (e.g., where people live and work, their homes, and their communities).

- A detailed plan of action to engage our communities in actions to reduce trauma and its consequences.

## The Public Health Model

**A community approach to preventing and treating illnesses.  Its premise is that caring for the health of an individual protects the community, while**—**in turn****—****caring for the health of a community protects the individual**—**with society at large reaping the overall rewards.**

**The Public Health Model**

## “The course of history is directed by the choices we make, and our choices grow out of the ideas, the beliefs, the values, and the dreams of the people.  It is not so much the powerful leaders that determine our destiny as the much more powerful influence of the combined voices of the people themselves.” 
Eleanor Roosevelt
“Tomorrow Is Now” (1963)

- Eleanor Roosevelt
*“**Tomorrow Is Now” (1963)*