When I entered the field of public health, my journey, learning, and development in the faculty and field of medical sciences opened my eyes and mind to scholarship that helped me make sense of so many things I had encountered in my life and mental health advocacy.
One of the areas to which I was drawn was adverse childhood experiences (ACEs). There is still a research proposal among my work that I cherish, titled “The association of childhood adversity with mental illness in adults;” a work deferred for a while but hopefully one that will be completed in my lifetime.
What attracted me to this issue and elevated my understanding of trauma were the associations I could make from my life given what the literature was saying. I began to interrogate my own early-life experiences wondering how some of them may have affected me or interrupted my life’s trajectory over the life course.
Later, prison mental health became another area of interest. I remain curious about what broke in people, and when, that would lead to criminality and recidivism. The mental health and rehabilitation of those incarcerated and imprisoned is a concern too, because global research shows more than 50 per cent of those have a diagnosed mental illness.
The World Health Organization (WHO) say ACEs refer to “some of the most intensive and frequently occurring sources of stress that children may suffer early in life.” Traumatic experiences may include multiple types of abuse, neglect, witnessing community violence, violence between parents or caregivers, and suicide events among family members or close relatives.
The US Centers for Disease Control and Prevention (CDC) says that ACEs result from “potentially traumatic events occurring in childhood (0-17 years).” These include “aspects of the child’s environment that can undermine their sense of safety, stability, and bonding” (cdc.gov).
Conditions such as divorce, being raised in households with someone living with mental health disorders, or with substance misuse/abuse, and/or living in a family/household where a member has been imprisoned are all traumatic experiences.
Additionally, socio-economic factors such as hunger, homelessness and unstable housing also have long-term impact. And these examples do not completely list adverse experiences.
The thing to pay attention to is that ACEs have long-term negative impacts on health, and well-being. There is also research to support that early intervention into children’s wellbeing can positively impact later-life and long-term health, opportunity and/or wealth, and levels of criminality.
Sometimes, as we try to make sense of the exhausting social circumstances in which we find ourselves in this national community, I am reminded how common and pervasive adverse experiences are and reflect on the detrimental long-term effects that carry into adulthood.
There are people who remain more vulnerable to these experiences than others. And when we see people with the same or similar experiences making different choices and choosing different pathways, we take account of the risk and protective factors that could explain behaviour.
As we pursue the issue of trauma and widen this discourse about what happened to us it is essential to learn how early experiences shape one’s identity, sense of safety, and emotional development and to help adults understand how childhood environments shape human functioning.
Consider that 75 per cent of mental illnesses occur before age 25 and that younger people have the lowest levels of access to mental health care across all ages and the issues becomes more visible. Without early intervention many of our young people could develop into adulthood with chronic mental disorders and could experience decades of unproductive adult life.
Consider that the adults among us may be living with unhealed trauma but that early interventions can lead to greater psychosocial healthiness in adulthood.
Know that many adverse health outcomes, both mental and physical, could be avoided if national planning included investment in the minds and mental health of people and if social programming focused on better protection for all our children.
Ponder too, that even for adults, mental health interventions are severely under resourced.
Research on the ACEs has given us a better understanding of the long-term mental and physical health outcomes from psychological impacts in early life. But as we grapple with societal breakdowns, we must know the change we hope to see will not happen once mental health remains on the periphery of health, health planning and financing, and healthcare innovations and interventions.
