At Ballad Health, we are committed to thinking outside traditional boxes to address social determinants leading to addiction throughout the Appalachian Highlands region of Northeast Tennessee and Southwest Virginia.
The scientific findings of the Adverse Childhood Experiences study identify experiencing childhood adversity without a support system as a major risk factor of addiction. With that in mind, Ballad Health has issued a call to action to regional professionals and is equipping many of them with trauma informed care training. However, since I first learned about the ACEs study in 2014, I’ve noticed a demographic often left out of community conversations to help reduce ACEs: law enforcement.
Before coming to Ballad Health, I spent almost seven years directing programs to reduce drug-related and violent crime for the Johnson City Police Department. It was there I first learned about ACEs and developed a framework for a trauma informed system of care – one that was recognized in 2018 by the SAMHSA-funded National Center for Trauma Informed Care as a model for other cities.
Initially, as I learned about the potentially devastating effects of toxic stress, I considered it through the lens of public safety. In an emergency department, there is a triaging method for seeing patients, with the most critical needs receiving care first. In a similar fashion, when triaging trauma from car accidents, drug busts, suicides, domestic violence or other incidents, members of law enforcement are often the first professionals on the scene – that’s why they’re called first responders. In processing these traumatic events, multiple agencies are typically involved with the same individuals. Therefore, as we work to raise awareness about ACEs and trauma informed care within the community, we must include members of law enforcement.
Earlier this year, I co-authored the Building a Trauma Informed System of Care toolkit through funding from Building Strong Brains of Tennessee, along with Dr. Andi Clements from East Tennessee State University’s psychology department. This toolkit can be accessed on the Tennessee Department of Children’s Services website on the Building Strong Brains/TN ACEs page https://www.tn.gov/dcs/program...ild-health/aces.html under the LEARN MORE section.
The toolkit includes a discussion on the development of Trauma Informed Policing, which was created during my role with the Johnson City Police Department. I saw an opportunity to reduce trauma for children present in justice-involved situations, by training law enforcement professionals in trauma informed care. By researching what law enforcement peers were saying about this topic, I found valuable recommendations from both the International Chief’s Association and the National Child Traumatic Stress Network, which can reduce trauma in these situations. In Trauma Informed Policing training, we’ve opened the conversation about trauma informed care with law enforcement and taught officers how they can become an intervention to reduce trauma for children when they are on scene and how behaviors they see in both children and adults might be a response to past trauma.
One way to begin the conversation with law enforcement in your community is with the program started by the West Virginia Center for Children’s Justice, Handle With Care. One of my goals at Ballad Health is to partner with law enforcement and school systems to launch Handle With Care throughout our two-state service area. School safety is a priority for local law enforcement; therefore, Handle With Care easily opens the door for a conversation about trauma informed practices and ACEs. The Handle With Care program is a simple partnership that has little or no cost to either law enforcement or the educational system. If a law enforcement officer encounters a child during a potentially traumatic 911 call, the officer alerts a designated person at the school before the next school day with the simple words, “[Child’s name], handle with care.” By initiating Handle With Care, we can alert officers to the existence of trauma and pave the way for more intensive training, such as Trauma Informed Policing.
(Johnson City, Tennessee Police Department)
A second way to engage law enforcement in a conversation about reducing the effects of trauma is by providing training that will address the importance of officer self-care. In an Aug. 2 report by ABC News, statistics released by Blue H.E.L.P., a nonprofit organization that tracks law enforcement suicides, reported 114 officers nationwide have taken their lives so far in 2019. Additionally, reported suicides are up 24% this year over the same period in 2018, when law enforcement suicides totaled 92. Included in Trauma Informed Policing training are a few simple, cost-effective ways for police to gauge how officers handle the stress of the job by using the Professional Quality of Life Scale, located on the Provider Resilience app. This self-scoring assessment is not a medical or psychological assessment, but it scores three areas: compassion satisfaction, compassion fatigue and, the most dangerous to officer mental health, secondary trauma. Along with scoring, the training identifies local resources available to officers for processing on-the-job trauma. Above all, processing trauma is not a character weakness, and Trauma Informed Policing training seeks to remove the stigma around accessing these resources.
(Oklahoma City Police Department Lateral Academy cadets; Becky Haas, Trauma Informed Administrator Ballad Health; far right, Captain Ryan Boxwell, Training and Recruitment OKCPD)
The overall learning objectives for Trauma Informed Policing consist of: Age-appropriate ways to reduce trauma for children on scene
- Why members of law enforcement should learn about trauma
- What is trauma?
- Prevalence of trauma
- Effects of trauma on brain development
- Understanding and using ACEs
- Examples of Trauma Informed Policing
- Trauma responsive approaches for officers
- Age-appropriate ways to reduce trauma for children on scene
- Tactical Breathing, healing gestures
- Five core messages for responding to domestic violence calls with children on scene
- Officer self-care
To date, this training has gained certification from both the Tennessee Peace Officer Standards and Training Commission (POST), as well as the Council on Law Enforcement Education and Training (CLEET) in Oklahoma. In both states, the training qualifies for three hours of officer in-service credit. During 2019, within the Ballad Health service area, we have provided training for the Johnson City Police Department, Bristol Tennessee Police Department and both the Sullivan and Buchanan counties’ school resource officers.
This summer, I also had the opportunity to provide training for the Oklahoma City Police Department. They were launching Handle With Care city-wide and wanted additional training for their officers. After three trips to Oklahoma City, I had trained the lateral academy cadets, the recruit academy, command and senior administrative staff and then lastly provided a 4.5-hour “Train the Trainer” for dozens of their training staff along with trainers from seven neighboring agencies, including CLEET staff. After providing the Trainer program, their training staff train all 1,200 Oklahoma City officers in Trauma Informed Policing.
After receiving trauma informed policing, department leadership made the following observations:
"I attended a Trauma-Informed Policing Class taught to our recruits in June of 2019. Becky Haas was a very good instructor and presented the material in a straightforward, realistic approach for law enforcement. Based on my experience as a crisis negotiator, it is easy to see the correlation and application of these principles to situations officers deal with on a daily basis. More importantly, officers need to recognize the indicators of trauma they experience as part of their job to prevent destructive behaviors in their own lives. We are happy Becky was able to prepare our department for all of our officers to receive Trauma Informed Policing.” - Wade Gourley, Chief of Police, Oklahoma City Police Department
Highly recommended. Trauma Informed Policing was informative and compelling. This training can make first responders more effective by putting some very practical tools in the toolbox to help understand people and circumstances encountered by law enforcement. In the process, law enforcement further benefits by better understanding reactions to trauma experienced personally or by those we know. The training ended with an emphasis on officer wellness and reviewing local resources for our employees. Very happy we received Trauma Informed Policing and the important information provided by Mrs. Haas.” - Jeff Becker, Deputy Chief, Oklahoma City Police Department
“Trauma Informed Policing is bridging the gap between mental health training and combating the effects of violence in our community. Since partnering with Mrs. Haas for training, feedback provided by experienced law enforcement proved that this type of training has never been addressed by law enforcement in Oklahoma. They were amazed how a little effort on their part could prove to be so beneficial to children and victims of violence as a whole. The self-care portion is right in line with how our department and the nation is looking at officer mental health and daily PTSD events. After providing the Train the Trainer in August to law enforcement trainers, specialists in the area of childhood trauma, victim’s services and officer mental health experts, it was invigorating to rekindle the importance of trauma informed care within our department and surrounding agencies. In the coming months, over 1,200 department employees, both sworn and non-sworn, will be presented the materials during quarterly in-service training. In addition, every recruit class in the future will continue to receive Trauma Informed Policing to prepare them to recognize trauma on the streets.” - Captain R. M. Boxwell, Training and Recruiting Division, Oklahoma City Police Department