Addressing Trauma through A Public Health Approach to Behavioral Health

Transcription

1 Addressing Trauma through A Public Health Approach to Behavioral Health National Network of Hospital Based Violence Intervention Programs (NNHVIP) September 2013 Arthur C. Evans, Ph.D. Commissioner, DBHIDS Faculty, University of Pennsylvania

2 Challenges Facing Philadelphians

3 The Current Service System

4 Overview 4 THINGS WE KNOW about trauma that inform the Public Health approach we re taking in Philadelphia

5 1: TYPES AND EXPOSURE TO TRAUMATIC EXPERIENCES ARE BOTH DIVERSE & WIDESPREAD A. Can occur across lifespan B. Can be a critical incident, chronic, and /or cumulative experience Woll, P. et al., 2013

6 2: WIDE RANGE OF EFFECTS AND SEVERITY Woll, P. et al., 2013

7 3: THERE ARE MULTIPLE POINTS & TYPES OF INTERVENTION Effective promotion, prevention, early interventions, and treatments are available along this continuum Woll, P. et al., 2013

8 4: COMMUNITIES AND SYSTEMS CAN PREVENT, CONTRIBUTE TO AND MITIGATE THE IMPACT OF TRAUMATIC EVENTS Woll, P. et al., 2013

9 This calls for a comprehensive approach that can have a broad impact with multiple strategies

10 HOW CAN A BEHAVIORAL HEALTH SYSTEM TAKE A PUBLIC HEALTH APPROACH? 4 AREAS:

11 #1: Broad Understanding of Trauma Beyond an Acute Stress Experience & Individual Treatment for PTSD Traumatic events exist at many ecological levels individual trauma like loss of a job, to family trauma like loss of employment/housing, to community trauma like a violent event or concentrated rates of violence, to societal trauma like 9/11 We need to redefine trauma beyond the individual level (treatment level) and intervene early and at various levels from individual to family to community to society

12 Hub of Hope Homeless outreach in a major transportation concourse

13 2: Effective Behavioral Health Services Trauma informed and trauma specific approaches 1 of the 10 core values of system transformation

14 Effective Specialized Treatment Supporting Trauma Informed and Trauma Specific Approaches Child and Family Traumatic Stress Intervention (CFTSI) Trauma Focused Cognitive Behavioral Therapy (TF CBT) Prolonged Exposure Dialectical Behavior Therapy (DBT)

15 Requires Intervening with Systems, Not Just Individual Clinicians Sanctuary Model

16 Philadelphia Alliance for Child Trauma Services (PACTS) A consortium of pediatric and other child serving agencies and behavioral health providers that see young people who may be traumatized

17 3: Strategic Cross System Partnerships Court System First Responders Police Crisis Intervention Training Child Welfare Department of Human Services Health Care Providers Emergency Room Departments

18 FIRST RESPONDERS/POLICE Trained in Crisis Intervention & Mental Health First Aid to better address individuals with behavioral health challenges The training actually empowers our officers to respond to any call with more understanding, empathy and respect for the person on the other end. Charles H. Ramsey Commissioner, Philadelphia Police Department

19 HEALING HURT PEOPLE Hospital based intervention Critical incident Opportunity for early intervention, prevention, and access to services and supports

20 4: Community Interventions, Strengthen Community Skills & Capacity Community Response Teams Mental Health First Aid Online and In Person Screening Faith Based Community Community Coalitions Mural Arts Porch Light Program Youth Move

21 It provided me with the confidence to extend a warm hand to anyone who needs assistance.

22 Community-based and Online Mental Health Screening: HealthyMindsPhilly.org HelpYourselfHelpOthers.org

23 Community Coalitions

24 A partnership between Mural Arts and the City of Philadelphia Department of Behavioral Health & Intellectual disability Services situates art and human connection to promote resilience, recovery, healing, and wellness

25 Communion between a rock and a hard place 2012 City of Philadelphia Mural Arts Program/ Phillip Adams and Willis Humphrey 4129 Woodland Ave Photo By Lovella Calica

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28 #1: Enhancing Physical and Social Environments Personal Renaissance 2010 James Burns JEVS ACT II 1745 N. 4th Street

29 #1: Enhancing Physical and Social Environments Personal Renaissance 2010 James Burns JEVS ACT II 1745 N. 4th Street Photo by Mustafah Abdulaziz

30 #1: Enhancing Physical and Social Environments Finding The Light Within 2012 James Bur 119 S. 31st Street

31 Behavioral Health Murals in Philadelphia

32 YOUTH MOVE Youth advocates for children s behavioral health and resilience

33 "It helped me be a stronger person. Now I feel like I can say anything I want. I'd say I feel free. Cintra Youth M.O.V.E. participant and youth advocate YOUTH MOVE

34 YOUTH MOVE

35 SUMMARY Trauma is a big issue, we need to take a wide view and have a broad impact, where we don t wait for challenges to occur and we don t rely only on professionally driven interventions This calls for a public health approach where everyone plays a role

36 IMPLICATIONS FOR HOSPITAL BASED VIOLENCE INTERVENTION PROGRAMS Recognize broader experience and potential impact of trauma Identify other resources and supports available to meet diverse needs of individuals Partner with other systems Connect to community resources Think outside the box

37 Arthur C. Evans, Ph.D.