From my work history as an emergency room RN case manager we seen a lot of chronic pain recidivism visits that truly became mental health evaluation however, would it have served the patient to have done an ACE/trauma screening instead? I actually understanding what you are attempting as Bessel van der Kolk addresses both PTSD and developmental trauma and the physical injury that both create within the body. Personally, speaking as a parent with a neurodiverse child, trauma comes from outside a family environment such as public school, where aversion intervention is applied to address disability-related behaviors which very much becomes developmental trauma. Applying what I am know learning about toxic stress and trauma, I look back at the care we gave ER patients and realized we missed the opportunity to screen for a trauma history- how trauma impacts their perception of pain, pain tolerance and other capacities regarding pain. A visit to the ER for help actually ends up re-traumatizing them. I transfer this knowledge onto chemical use, mental health (anxiety) and adaptive traits such as dietary, exercising and smoking. Health care exists too much on parentalism which re-traumatizes individuals. Physicians cannot simply screen though, they must know what to do with the results. SAMHSA has a great education series on trauma informed care which should be done in conjunction with trauma screens; no matter the diagnostic tool. I believe that all well child visits, like California, should screen for ACEs but we shouldn't stop there and screen adults too. There is a lot of good research why we should screen adults especially if they have children themselves. Research projects that tend to give the greatest savings (quality of life, higher achievements, cost savings) typically are the programs where a relationship exists between the professional and individual. Usually a nurse case manager or social worker that creates a safe, non-judgmental mentoring relationship that has been missing from the individual's life. Just look to Public Health's Nurse-Family Partnership program-amazing and consistent results. I can only tell you that in my state there is no such thing as a trauma screen and outside of one single ACE study specific to Native Americans, no other has been completed. That is a public health shame (in my opinion) as we have elevated mental health rates, alcohol usage/abuse and other disparities. Best of luck!
Teresa