Lasting effects

In Jeremy Wilson’s line of work, it does well to remember that people who act abusively have probably suffered abuse themselves. He offered an example of a schoolyard bully.

“When someone is displaying disruptive behaviors,” he said, “you can respond in that authoritarian, knock-if-off way, or you can say, ‘OK, there’s a reason this sixth-grader is pushing other kids down on the playground.’ Most likely, it’s not because the sixth-grader was born a mean, awful kid, but because they’ve experienced some level of trauma at home.”

Wilson, program manager for Butte County Behavioral Health, says severe trauma affects everyone differently, depending on factors such as mental health, family history and genetics. For pretty much everyone, however, traumatic experiences are more devastating earlier in life.

A growing body of research suggests early trauma can reverberate throughout adulthood. There’s even a term for it: ACE, which stands for Adverse Childhood Experience. Researchers say ACEs represent risk factors for addiction, violence, criminal behavior and chronic health conditions later in life. It’s a public health issue that impacts nearly everyone at least indirectly, said Matthew Reddam, a licensed marriage and family therapist.

Wilson and Reddam are both members of Butte County ACEs Connection, a coalition that formed about a year ago in response to a startling 2015 report from the Center for Youth Wellness. It shows that Butte County is the worst in California in terms of prevalence: 76.5 percent of residents have at least one ACE. The state average is 62 percent.

The group’s first priorities are raising awareness of ACEs and encouraging a wide shift in perspective. “It can’t just be a whole bunch of social-justice warriors,” Reddam said. “It has to be the entire community.”

The trauma can be neglect; emotional, physical or sexual abuse; domestic violence among parents; parental separation; or drug use or severe mental illness in the household. The more ACEs, the greater the risks. Relative to people who didn’t experience serious childhood trauma, those with at least four ACEs are more prone to a range of conditions (see infobox).

Reddam explained the relationship between ACE and disease. “It’s the root of so many of the symptoms we see,” he said.

“An adverse childhood event is not causation for cancer,” he added, “but it does force the individual to adapt in extreme ways. If you’re routinely sexually abused, your body and brain will adapt to tolerate those physical and emotional feelings with self-harm, alcohol abuse or overeating—things that will make you far more likely to develop health problems.”

Anna Bauer is program manager of First 5 Butte County, a commission dedicated to improving the lives of local children during the earliest stages of their development. She attributes Butte County’s disproportionate share of ACEs to the “intergenerational drug abuse/poverty cycle” that plays out in rural areas and the lack of local access to health care and social services.

“Frankly, I think those types of social services aren’t as valued politically in this part of the state,” she said. “Here, we value enforcement. Just look at how the county budget is distributed. I’m not saying that the decision-makers don’t care about people; it’s just a rural mindset where people can take care of themselves.”

Bauer is also a member of ACEs Connection. The coalition has broad participation, including representatives from local school districts, juvenile probation, Northern Valley Catholic Social Service, Youth for Change and Catalyst Domestic Violence Services, to name a just few organizations. Every other month it breaks into subcommittees dedicated respectively to outreach and education; research and policy; and helping the community become “trauma-informed.”

That term describes an individual, service organization, or health care system that recognizes the “widespread impact of trauma and understands potential paths for recovery,” according to the Substance Abuse and Mental Health Services Administration.

“It’s partly looking at how organizations approach the populations they serve,” Reddam said. “Do they recognize how past trauma might be affecting an interaction in the moment? Do they resist retraumatizing policies?”

An example of such an institutional policy, Reddam said, is punishing inmates in the criminal justice system—whether they’re adults or juveniles—with long-term isolation. If the inmate’s disruptive behavior is rooted in childhood neglect, seclusion may act as a trigger.

Difficult though it may be, it is possible for schools, child welfare organizations and police departments to incorporate trauma-informed practices, Wilson said. He pointed to the Chico Police Department’s Target Team, whose mission is to proactively address root causes of major community problems. Rather than solely taking an enforcement approach, the team attempts, for example, to connect homeless people—who likely have experienced more than one ACE—to mental health counseling, drug treatment and housing services.

Encouraging the community to shift its approach to so many problems is a major task, but the members of ACEs Connection are optimistic. For now, the local effort is unfunded.

“There is no grant,” Bauer said. All of the agencies represented in the coalition volunteer their time and what resources they can, helping host workplace trainings and roll out a public awareness campaign over the next several months.

Bauer hopes the public will listen. “You don’t need much money to change perspectives,” she said.