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"Moving from Understanding to Implementing Trauma-Responsive Services" — Takeaways from SAMSHA Forum in Johnson City, TN


Speakers and guests at the SAMSHA Forum included (l-r) Mary Rolando of the Department of Children's Services; Chrissy Haslam, First Lady of Tennessee; Dr. Joan Gillece, SAMSHA Center for Trauma Informed Care; Dr. Andi Clements, East Tennessee State University; Becky Haas, Johnson City Police Department; Carey Sipp, ACEs Connection, and Robin Crumley, Boys & Girls Club of Johnson City/Washington County.

It was easy to be both inspired and a bit overwhelmed at the Substance Abuse and Mental Health Services Administration (SAMSHA) forum hosted by Johnson City, TN, and Northeast Tennessee ACEs Connection last week. 

Amazing work is being done in Johnson City by more than 30 organizations that have come together under the leadership of Becky Haas of the Johnson City Police Department and Dr. Andi Clements of East Tennessee State University to create this growing system of care. Just keeping track of the number of programs (31) -- and imagining the amount of time, talent, and treasure going into this effort to help the area become a Trauma-Informed Care Community -- is a bit overwhelming, in the best of ways.

Below are just a few of the quotes and takeaways from the day-long seminar, which featured more than 20 speakers, and was almost balletic in how beautifully one portion of the program flowed into the next; how each speaker's comments supported those of the prior speaker, setting the stage for the next.

"We all want to decrease crime. We want to see people who need health and human services get those services, and it's all interconnected. Leadership is very important — to have a commitment and a passion for wanting to see your community survive," said Stephanie McCladdie, SAMSHA regional administrator for Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee.

"If you prevent things, you don't have to fix them," said McCladdie. "We have a lot of talented people sitting in our prison system. We have to look at how we can prevent trauma."

"Include the voice of people you are serving, " said Dr. Joan Gillece of the National Center for Trauma Informed Care. She talked about the need to have peer support immediately available for people receiving Narcan, the drug given to revive and save people who have overdosed on opioids.

To help people heal, and help prevent childhood trauma, "We must switch from control to comfort," said Gillece. Working with women prisoners, she said, "there was overwhelming trauma." Using a strengths-based approach, to see what people are doing right instead of what they are doing 'wrong', and going to comforting people first, instead of trying to control them, is what works, said Gillece.

"You don't have to be a therapist to be therapeutic," she said, in talking about the importance of having trauma survivors support other trauma survivors. "We must see people as more than their trauma. Up to 75% of women in substance abuse treatment report trauma histories. There is meaning in behavior."

Oftentimes, "trauma survivors push people away rather than be vulnerable," according to Gillece.

Quoting SAMSHA research, Becky Haas of the Johnson City Police Department added, "The number one reason for homelessness is trauma."

"In beginning this work, I filled a notebook with trauma-informed practices being done in other places, it mostly came through ACEs Connection," said Haas.

"Our towns are burning, and we must sound the alarm," said Haas when speaking about trauma, the impact of trauma on drug abuse, homelessness, and gangs. "If I knew I had the ability to prevent cancer, and I did nothing, I couldn't live with myself. Preventing trauma is the same thing. We can create a trauma-informed community that helps prevent trauma. Why give out Band Aids when we can do some healing?"

"Imprisonment has not reduced Tennessee's drug problems. The cause of drug addiction isn't drug addicts," said Dr. Andi Clements of East Tennessee State University, who partners with Haas in working toward making Johnson City a trauma informed community. "If you are looking to self-medicate, you will self-medicate."

"People (with addiction problems) must be heard," said Clements. Ninety-two percent of homeless mothers report severe trauma histories."

"Don't ever underestimate the impact you can have on the life of a child," said Robin Crumley, President and CEO of the Boys & Girls Club of Johnson City/Washington County. This club has a trauma-informed care room, where children can go to feel safe. "We can't help everyone can help someone," she added.

"We know children are stressed, distracted, and strained by toxic stress. ACEs science and the trauma-informed communities work being done here could help every one of our state's problems," said Crissy Haslam, First Lady of Tennessee.

"My husband and I are so proud of Johnson City, Tennessee, and how it is a model for the rest of the state, as we work to make Tennessee the best place to live and work and raise a family," said Haslam. 

"A lot of states are working toward becoming trauma-informed; Tennessee is on the forefront," she added. 


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Jane Stevens (ACEs Connection staff) posted:

Does Care 7 use the ACE survey as you do, Peter?

I was told the  Care 7 counselors use the ACE survey, but I don't know to what extent.

My first day on the job, I interview a man that I felt had a medical problem. So, as he drank his Jack & Coke in an insulated 32 oz sippy cup (It's hot in Tempe), I asked him "You don't have to answer my question. But did you have a rough childhood?" His reply was "Just consider me as the hated red headed step child. My father beat me often and one time I couldn't get out of bed for 3 days."  I told him that his medical condition and as I looked as his beverage cup, were two conditions from his childhood. With a real surprised look he said you're kidding. I replied "no". On be-known to me I met his two grand children earlier. I would describe them of a condition I call Darkness Behind The Eyes. It doesn't take much of a peripheral lens to see the need that is out there.

I didn't have my handouts the first day. Be sure I had them the rest of my stay.

Jane, You should contact them and see if they will share their Ace survey from 9th graders. 20% scored having a family member being incarcerated. The other %s on most questions were higher than the original 1986 ACE Survey.

This Spring I was invited to shadow Care 7 community trauma mitigation team in Tempe, AZ. The team is on call 24-7, responding to 5 call per day on average, and serves a population of 180,000. My first day was a residential fire which displaced the physical and cognitive impaired home owner. The team member and I worked with the fire department to retrieve mail so that we could determine the insurance home owner policy and initiate the coverage for temporary housing. We also provided peripheral mitigation for children and families that could not get back to their homes until the fire was out. Day four the team included a victim advocate, a team member and myself. The team provided legal advocacy, emotional first aid and transportation to a proper medical facility. The client was transgender, post rape and suicidal.  

Care 7 is another great tool communities could use in the mitigation and prevention of trauma in people's every day lives.



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