It was more than a piece of parchment bearing the governor’s signature. Illinois Governor J.B. Pritzker’s resolution declaring May 15, 2019 as the state’s first Trauma-Informed Awareness Day marked a high-level recognition that, where state policy is concerned, trauma matters.
The resolution and resulting proclamation Pritzker signed also calls for legislators to consider childhood brain development, early adversity and buffering relationships when making policy decisions; it urges all state employees whose work involves children and families to learn about ACEs and trauma-informed care.
The legislation was one more step in a years-long journey of education, training, data-collection, research and networking by the Illinois ACEs Response Collaborative at Health & Medicine Policy Research Group, a policy and advocacy think tank focused on health equity.
Collaborative director Lara Altman was gratified to see concepts and language promoted by the group—how trauma lies at the root of health disparities; how being trauma-informed also means noting individual and community strengths—embedded in the language of the resolution.
But the question remains—in the Collaborative’s policy agenda, as well in its work with hospitals, state health departments and schools—What next?
The legislation “shows a real awareness that’s growing, a real desire to think about childhood adversity and create support,” Altman says. The Collaborative’s task now “is to think about: How do we follow up on that? How do we help state agencies become trauma-informed?
“We’ve laid a lot of groundwork, a lot of general awareness-raising. How do we take it deeper?”
In the two years since Altman became the Collaborative’s director, the group has sharpened its focus, both inwardly and without, on taking those next steps. A strategic planning process that included a survey of Collaborative members, qualitative interviews with other project leaders from Mobilizing Action for Resilient Communities (MARC) and a couple of leadership team retreats resulted in new ways of framing and organizing the work.
“We wanted a more explicit emphasis on equity,” says Altman, a value now reflected in the Collaborative’s vision statement: “A thriving and equitable Illinois in which individuals, families, communities, and all systems and sectors work together to prevent trauma, heal, and flourish.”
The Collaborative organized its work into three wide spheres: policy and advocacy; capacity-building efforts that include trainings and trauma-informed organizational change; and research translation and dissemination.
To advance policy that is trauma-informed both in its making and in its effects, the Collaborative developed a two-page “Trauma-Informed Policymaking Tool” that underscores the importance of safety, transparency and the inclusion of people with lived experience.
A scan of trauma-informed policy both in Illinois and other states—a Collaborative project due to be released in May—“will give us a sense of where our strengths are, as a state, and what are the trends,” Altman says.
For the Collaborative, that second bucket of “capacity-building” means working with hospitals and health departments wishing to boost their trauma-awareness—an effort that calls for listening, guiding and responding to the groups’ priorities.
The Trauma-Informed Hospital Collaborative, formed in 2017 and now comprising 18 members, showed strong motivation to improve staff wellness, with trainings on preventing burnout and reducing secondary trauma through practices such as “Schwartz Rounds,” a grand rounds-style examination of how patient care affects health workers’ emotions and well-being.
The ACEs Response Collaborative also leads a virtual learning group of local health departments across the state; initially, Altman says, she presumed those departments would focus on assessment of their trauma-awareness and in-house practices, but more are interested in building partnerships across their communities, networking with school districts and the judicial system.
The Collaborative’s training efforts now extend beyond the basics. “The Trauma 101 piece is really important, but what do we do after that?” Altman says. In response to calls for deeper training, and in sync with the Collaborative’s renewed focus on equity, the group developed a new training module on historical and collective trauma.
“It grew out of a sense that we still weren’t talking about structural violence, the lasting impact of slavery and Jim Crow. We presented it to the Office of Social and Emotional Learning at Chicago Public Schools, and it really resonated for them.”
Already, there are seven requests—including from juvenile justice, primary healthcare, and statewide child abuse prevention organizations for the training. The Collaborative also offers monthly webinars that draw as many as 300 participants; recent topics have included clinician burnout, “Segregation Stress Syndrome” and Early Childhood Court Teams that prioritize the needs of infants and toddlers.
One aspect of the Collaborative’s work that has not changed is its commitment to partnership and collective impact. In May 2019, the Collaborative, along with the Chicago Teachers Union and several youth-focused organizations, co-hosted a conference on trauma-responsive schools. About 400 people attended; the focus was on interdisciplinary work, with sessions on critical race theory, self-care, cultural competency and restorative justice.
And in September, the Collaborative and the Chicago Department of Public Health hosted the first “Trauma-Informed Chicago Summit: Connecting for a Resilient Future,” a gathering of more than 500 people—including police officers, school personnel, immigration advocates, health care workers, violence prevention activists and unconventional partners such as representatives of the Joffrey Ballet—that aimed to be both a celebration and a call for action, “meant to help people engage with each other cross-sector and to think about what a resilient and thriving Chicago would look like,” Altman says.
Mayor Lori Lightfoot spoke. A 15-year-old singer-songwriter whose work focuses on trauma recovery opened the day-long conference. Attendees took part in a bingo-style game about breaking down silos and a youth-led art project about resilience. “This kind of movement-building is hard to measure,” says Altman. “It was really powerful to have everyone there together.”
Currently, she said, a cross-sector group that includes many Collaborative members is helping the city’s health department develop a trauma-informed transformation toolkit on a tight deadline. “That would not be possible without the combined expertise of all these groups coming to the table.”
As the Collaborative has worked to hone its focus and deepen its commitments, the group’s connections to MARC—to a national ACES, trauma and resilience movement—have provided advice, perspective and momentum. Altman consulted with MARC leaders in Alaska when working on the policymaking tool; she asked Kansas City leaders about strategies for engaging the business community. Robin Saenger, founder of Peace4Tarpon in Florida, did a local presentation on cross-sector engagement.
“Being connected nationally has been so helpful in terms of staying abreast on what everyone else is doing—what’s working and what’s not,” Altman says.
Anndee Hochman is a journalist and author whose work appears regularly in The Philadelphia Inquirer, on the website for public radio station WHYY and in other print and online venues. She teaches poetry and creative non-fiction in schools, senior centers, detention facilities and at writers' conferences.
Mobilizing Action for Resilient Communities provides tools and inspiration—by networks, for networks—using the science of ACEs to build a just, healthy and resilient world.