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Opinion: All Doctors Should Practice Trauma-Informed Care [calhealthreport.org]

 

By Bob Erlenbusch and Drew Factor, California Health Report, November 20, 2019

“Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today,” Dr. Robert Block, former president of the American Academy of Pediatrics, has been widely quoted as saying.

According to the Adverse Childhood Experiences Study, conducted in the 1990’s by the Centers for Disease Control & Prevention and Kaiser Permanente, adverse childhood experiences are common, and the resulting health and behavioral health issues span a lifetime.

What are adverse childhood experiences, commonly referred to as ACEs? The study identified three types: abuse, neglect and household dysfunction. Since the study, the list of ACEs has been expanded to include living in unsafe neighborhoods, food insecurity, homelessness, bullying, income insecurity, discrimination and racism.

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“Thus, it should be standard practice for medical professionals to screen and assess for trauma in a safe environment. It is critical that primary and behavioral health systems have communication channels to inform each other about a person’s trauma and its effect on their mental health and physical wellbeing.

In order to achieve this outcome, we are proposing state legislation to mandate trauma-informed care education in all California medical, dental and nursing programs. In addition, we propose that all major medical groups undergo similar training of their administrators, staff and clinicians.”

1. I hope that “trauma-Informed” Care is not just screening for an ACE Score. 

2. For many traumatized people, a doctor’s office will NEVER be a safe environment no matter what you do. 

3. Many of us who have been traumatized, know how utterly inept “behavioral health” is especially that available to the poor and many know how much we do not want communication between these two groups.   A great majority of the patients I have taken care of... don’t trust CMH.

They act patronizing, paternalistic and do not respect the patient’s inherent knowledge of what he/she needs.  They push and sometimes force dangerous drugs like antipsychotics on traumatized children.   This type of coercive “Care” is not trauma-Informed. 

What do you all think trauma-Informed care is?  I thought it was supposed to be ... treating people in a respectful manner that doesn’t retraumetize them.   Now ... I don’t know what you all have in mind.   Whatever it is, I hope it helps and doesn’t hurt patients especially children. 

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