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How Can Communities Give 'Trauma Informed' Care?


An emerging health care approach factors in the lasting effects of trauma.

In 2016, the Winnebago County Health Department asked the community about top health concerns so it could put together a Community Health Improvement Plan. Several issues made it to the top of the list.

Cynthia Hall is the Department’s Director of Strategic Initiatives. 

“And they told us three things," she explained. "Mental health was one of them. Maternal and child health was another, and violence was the third.”

She says the Department found that trauma was a concept common to all three of these concerns. But identifying trauma can be a complex process.

In response to the health plan’s findings, the Winnebago County Health Department created working groups to address trauma within the community.

“First we’re trying to build awareness with the community," she said. "We want to empower our residents. We want to build healthy relationships, we want to implement trauma-informed policies, and we want to reduce re-traumatization.”

The Winnebago County Health Department came up with these priorities at a summit in March. While methods may differ, they focus on educating agencies and the community about the signs of trauma and how to address those who have been affected by it. Hall uses the example of a child seeing a physician after a teacher reports problems paying attention in class.

“Although his behavior might indicate ADHD, it might be a traumatized child that needs a different type of assistance. So we want healthcare providers to be aware as well," she said.

Hall says the next step for her group is to better coordinate with individual agencies in the area.

“They’ve all been independently working on this, but now we’re trying to come together as a bigger collaborative to create a collective impact and really raise that awareness and make some change in making our community become more resilient,” she said.

DeKalb County’s government created a trauma-informed committee last year, and it’s reaching out to educators and other professionals around the area. Bri Kness is coordinator of the Juvenile Justice Council and part of that movement. She says in the case of the child with ADHD, it’s a matter of changing a teacher’s mindset from “what’s wrong with that kid?” to “what’s happening with that kid?” and making proper accommodations.

“Maybe just giving that child a little more time to get an assignment done, or maybe letting them just go take a walk down the hall to get a drink, just giving more space, giving them some kind of a fidget--just to go take a breath,” she said.

Kness stresses that trauma isn’t an excuse for the child’s behavior, but the accommodations can help them learn better in the classroom. The trauma informed committee also tries to network different educational and social service agencies. Then, if a teacher suspects there’s something bigger at work in the child’s life, they can connect a family with the appropriate group.

“So we can know, ‘Hey, this kiddo needs this type of service,’ and so we can more easily remember, ‘ I know that family service agency offers this type of counseling,’” she said.

Kness views the county’s trauma informed committee as the hub of a wheel for services and education, But other groups have different goals, such as showing how trauma fully affects an individual’s health.

Amy Brandon is a Director of Prevention and Counseling Services at Safe Journeys. This organization treats victims of domestic violence and sexual assault in LaSalle and Livingston County, and Brandon says a big thing they watch for is post-traumatic stress disorder.

“It’s kind of like a cluster of symptoms and it has to do with like a hypervigilance, or a re-experiencing, heightened anxiety, maybe problems sleeping. All of those things can be related to the trauma that someone has experienced in a domestic violence or a sexual violence situation,” she said.

Brandon says recognizing these signs is important in their treatment process, particularly since repeated exposure to the same trauma can affect a person throughout their life. Safe Journeys focuses on identifying a victim’s individual triggers, developing coping skills, and managing their mental health symptoms.

“So that they can continue with their everyday lives and feel more and more confident doing so."

Brandon says her group also educates law enforcement officers, because some responses to trauma can be important factors in how investigations are conducted.

“Their memories are not necessarily reliable about what happened to them or maybe the timeline of what happened," she said. "The memory can be profoundly affected when it’s under extreme stress.”

Diane Farrell is Chief Clinical Officer of North Central Behavioral Health Systems. She says that the whole scope of what trauma is, is the person feeling helpless and that their life is in danger. Her organization serves LaSalle and nearby counties and is also working to serve the needs of the region.

Farrell says it can also bring situations that cause trauma out into the open.

“The more we can decrease the secrecy about whatever type of abusive event is happening, whether it’s happening in the home or any place where people feel powerless, the goal is to reduce secrecy and increase a person’s feeling of safety and confidence," she said.

Winnebago County's Cynthia Hall says Wisconsin is making efforts to become a trauma informed state. Ultimately, the hope is that this model can address a universal series of issues.

“If you think about some of the conditions that we’ve talked about (family violence or unemployment, substance abuse), those know no bounds. So I think a trauma-informed community would benefit virtually every community.”

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