Congressional briefing addresses trauma in an ever changing political and policy environment

 

Sen. Heidi Heitkamp at lectern—(l to r) Kana Enomoto, Zach Kaminsky, Judge Dan Michael, Dr. Joe Wright, and Wendy Ellis
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The first congressional briefing on trauma held during the 115th Congress and the new administration was held May 11 before a rapt audience of Hill staff amidst a swirl of controversy around the firing of FBI Director Comey and the speculation that the fallout will derail progress on the domestic policy agenda.

The themes addressed in the afternoon briefing were similar to those covered in the three briefings held during 2016. Co-hosts Senator Heidi Heitkamp (D-ND) and Senator Dick Durbin (D-IL) gave opening remarks. Heitkamp said she was motivated by widespread trauma in Native American communities; Durbin said his motivation came from those urban communities where violence is pervasive. Both emphasized the need to address the root causes of trauma in order to solve many multi-faceted social problems.

Senator Dick Durbin (D-IL)
Senator Durbin just before speaking at May 11 briefing.  (l to r) Max Kanner with Sen. Durbin, Megan DesCamps with Sen. Heitkamp, Natalie Kyles, Angelique Day with Rep. Davis


The purpose of the briefing was to continue the education of Hill staff on the science of adverse childhood experiences (ACEs) and the solutions that are being developed to reduce ACEs and mitigate their effects, as well as to familiarize staff and advocates about the “Trauma-Informed Care for Children and Families Act,” S. 774 and H.R. 1757, introduced earlier this year. In addition to Heitkamp and Durbin, five other senators—all Democrats—have signed on to the bill (Franken of MN, Booker of NJ, Gillibrand of NY, Schatz of HI, Peters of MI). Sponsors of the House bill authored by Rep. Danny K. Davis (D-IL) include four other Democrats.

While bi-partisan support has not materialized, nearly 70 national and grassroots organizations have endorsed the legislation (list attached). They include the National Education Association, Mental Health America, American Psychological Association, National Council for Behavioral Health, United Way Worldwide and Zero to Three.

Organizers of the event included the American Academy of Pediatrics, Futures Without Violence, the National Council of Juvenile and Family Court Judges as well as the Campaign for Trauma-Informed Policy and Practice (CTIPP), an original sponsor of the 2016 briefing series. CTIPP is a national organization formed to advocate for public policies and programs at the federal, state, local, and tribal levels to address trauma across the lifespan.  

Wendy Ellis, project director of the Building Community Resilience Collaborative, Milken Institute School of Public Health, moderated the session that included leaders from the health care and justice sectors as well as a scientist in field of epigenetics, and a key official of the US Department of Health and Human Services (HHS). Ellis described current data on the issues addressed in the briefing—addiction, mental health and violence—with a focus on “the pair of ACEs,” a phrase to describe an environment where adversity exists both at home and in the community. She highlighted the major goals of the trauma-informed care act: foster collaboration across sectors and community coordination; improve coordination across federal programs; support a trauma-informed workforce; support innovation in trauma-informed prevention and care; and incentivize working smarter, leverage existing resources.

Presentations by the following speakers will be posted shortly on the trauma section of Senator Heitkamp’s website (click on “Events” on the top toolbar):—Dr. Joe Wright, MD, MPH, FAAP, Professor and Chair of Pediatrics at Howard Univ. College of Medicine
— Dr. Zach Kaminsky, PhD, Johns Hopkins School of Medicine
‑—Kana Enomoto, Acting Deputy Assistant Secretary for Mental Health, HHS
—The Hon. Judge Dan H. Michael, Juvenile Court of Memphis and Shelby County, TN

Dr. Joe Wright of Howard University
Joe Wright, MD, MPH, FAAP, Professor and Chair of Pediatrics at Howard University College of Medicine 


Wright said that there is a need to “retrofit” medical education to include ACEs science to give future pediatricians the information they need to improve health. He lauded the work of Dr. Nadine Burke Harris, noting her innovative screening for ACEs in a clinical setting. Kaminsky provided a primer on epigenetics (the field that seeks to identify biological markers that reflect the interaction of genes and the environment), saying that epigenetics is “the cause of, and solution to all of life’s problems.” Kana Enomoto, longtime member of the staff of the Substance Abuse and Mental Health Services Administration (SAMHSA), now serving as acting deputy assistant secretary for mental health (a new position created in the 21st Century Cures Act), described the many SAMHSA programs that address trauma. She called the National Child Traumatic Stress Network “the jewel in the crown” of SAMHSA’s work in trauma.

Judge Michael of the Memphis/Shelby County Juvenile Court told dramatically contrasting stories of two young people with traumatic childhoods and who had both committed serious crimes—one had a bad (and expensive) outcome while the other was a “success story.” One severely abused child did not receive evidence-based treatment and was jailed. The second child received evidence-based treatment, cognitive behavioral therapy (CBT), and supports at a crucial time during rapid brain development, according to Michael. She is now a straight-A student and will be paying taxes rather than being incarcerated at a cost of $40,000 a year, he said. He also addressed the issue of vicarious trauma, experienced by judges like him and other lawyers who are exposed to disturbing cases of abuse and neglect.

(l to r) Dan Press, Kimberly Konkel, Zach Kaminsky, Wendy Ellis
(l to r) Dan Press, Kimberly Konkel, Zach Kaminsky listen as Wendy Ellis describes a recent experience she had of being singled out by a shuttle bus driver. See “When Racial Targeting Happened To Me”)


According to Dan Press, who heads the CTIPP Policy Committee, the work ahead includes building a broad-based coalition of organizations to support legislative and administrative changes (building on the nearly 70 organizations supporting the Heitkamp-Durbin-Davis bill), educating policymakers across the political spectrum through face-to-face meetings and briefings, and activating people at the grassroots community level to advocate for trauma-informed policies and programs at all levels of government.

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I'm glad the Judge raised the issue of vicarious trauma. I'd read about "Juror Stress" .....some of the Jurors at Timothy McVey's trial developed full-blown PTSD, but this is the first I'd heard of Judges acknowledging it, and that kind of leadership and advocacy is needed for Judges, too!

Dr. Sumrok, your state was well represented by Judge Michael whose presentation was so moving and compelling.  I am excited about the potential to influence national policy by sharing the innovations and lessons learned in states such as Tennessee. 

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