Justice Library

Racism, Chronic Disease, and Mental Health: Time to Change Our Racialized System of Second-Class Care In this article, we describe how the “weathering hypothesis” and Adverse Childhood Experiences set the stage for higher rates of chronic disease, mental health disorders and maternal mortality seen in African American adults. We illustrate the toll that untreated and overtreated mental health disorders have on Black individuals, who have similar rates of mental health disorders as their white counterparts but have fewer outpatient mental health services and higher rates of hospitalizations. 

Trauma-Informed Care: The Importance of Understanding the Incarcerated Women This study assessed the significance of trauma-informed care (TIC) in the recidivism rates of incarcerated women. A retrospective longitudinal survey was conducted. ACE scores were evaluated and documented through a self-reported survey. Seven years of Correctional Offender Management Profiling for Alternative Sanctions registry documentation was assessed. Descriptive statistics were utilized to define patients and evaluate patterns of recidivism after implementation of trauma-informed approaches to care. There is strong evidence associating lower recidivism rates for those who participate in TIC and trauma programs than for those who do not. This evidence supports further evaluation with a serious potential impact of reduction in recidivism and improved trajectories for incarcerated women and their families

The Intersection and Dynamics between COVID-19, Health Disparities, and Adverse Childhood Experiences The coronavirus disease 2019 (COVID-19) pandemic is shining a spotlight on health disparities that have long been overlooked in our society. The intersection between Adverse Childhood Experiences (ACEs), longstanding health disparities, and COVID-19 cannot be ignored. The accumulation of traumatic events throughout the childhood and adolescent years can cause toxic stress in the absence of supportive adults. This repetitive activation of the stress response system can be a catalyst to long-term, negative effects on both the body and brain. A major factor to appreciate is that ACEs do not affect all populations equally. ACEs disproportionately affect groups that have been historically oppressed. The current COVID-19 pandemic highlights this point when observing both case rates and fatality rates of the virus and has the potential to create a new series of long-term health conditions that will disproportionately affect marginalized communities. A foundational first and critical step of adopting a trauma-informed approach will help lead to system change, advance equity, and create a setting of mutuality and empowerment for our patients.

Receipt of Behavioral Health Services Among US Children and Youth With Adverse Childhood Experiences or Mental Health Symptoms Purpose of the study was to estimate the proportion of children with either high levels of ACEs and/or high levels of mental health symptoms who were not receiving services from behavioral health professionals. This cross-sectional study included 11,896 children who participated in 3 National Surveys of Children’s Exposure to Violence (NatSCEV), which were nationally representative surveys conducted in 2008, 2011, and 2014. The surveys entailed telephone interviews with youth aged 10 to 17 years and caregivers of children aged 2 to 9 years. Data were analyzed from February to August 2020.

Planning for Youth Emotional Health in Unruly Environments: Bringing a Trauma Informed Community Building Lens to Therapeutic Planning The paper seeks to explore two primary questions. How was TICB (Trauma Informed Community Building) integrated into practice and how did it support health outcomes for youth, if at all? Second, what are the limitations of the TICB model and is it a sustainable approach to planning for emotion in unruly environments? The article closes with a discussion of the potential contributions and limitations of TICB in engaging historical, structural (systems level) and individual trauma into youth community building.

Adverse Childhood Experiences Prevention Strategy This resource outlines CDC’s specific goals and objectives for ACEs prevention and response. The goals and objectives aim to prevent ACEs before they happen, identify those who have experienced ACEs, and respond using trauma-informed approaches in order to create the conditions for strong, thriving families and communities where all children and youth are free from harm and all people can achieve lifelong health and wellbeing.

The Interrelationship Between Empathy and Adverse Childhood Experiences and Their Impact on Juvenile Recidivism Results show youth with higher ACE scores have less empathy at admission and both ACEs and empathy predict recidivism. Most importantly, large gains in empathy are able to dampen the effect of ACEs on recidivism

Health Risk Behaviors and Resilience Among Low-Income, Black Primary Care Patients This study describes an intervention with low-income, Black primary care patients and their experience in changing a health risk behavior. Participant themes, including behavioral coping, personal values, accomplishments and strengths, barriers and strategies, and social support, are understood in relationship to health behavior theories

Sociodemographic Characteristics, Adverse Childhood Experiences, and Substance Use and Psychiatric Disorders Among Adolescent-Limited, Adult-Onset, Life-Course-Persistent Offenders and Nonoffenders This study compared sociodemographic characteristics, adverse childhood experiences (ACEs), and substance use and psychiatric disorders between adolescent-limited (AL), adult-onset (AO), life-course-persistent (LP) and nonoffender (NO) groups using a large U.S. general population survey. the results of this study identified several sociodemographic factors, ACEs, and types of psychopathology that differentiate AL, AO, LP, and NO offenders that can help inform prevention and intervention strategies designed to prevent offending and shorten criminal careers

Trauma-Informed Care and Cultural Humility in the Mental Health Care of People From Minoritized Communities This article outlines general principles of trauma-informed care and ways to enact it. Because the situations in which trauma arises, the ways in which it is conceptualized, and how patients respond to it are influenced by both culture and individual factors, a cultural humility approach is also described and recommended. Psychiatrists can navigate the complex terrain of cultures and social backgrounds in the clinical encounter and can promote healing when treating patients who have experienced trauma by adopting a trauma-informed care approach and an attitude of cultural humility.