The Impact of Trauma and Adverse Childhood Experiences (ACEs) on Mental Health and Well-Being

The Impact of Trauma and Adverse Childhood Experiences (ACEs) on Mental Health and Well-Being

Trauma-informed care is a care approach that promotes healing and a safety culture by acknowledging a patient’s life experiences in care delivery. It recognizes that traumatic experiences and their sequelae are tied to the patient’s wellness, takes proactive steps not to re-traumatize the patients, and establishes a trauma-informed environment across the care continuum. It is based on the understanding that a significant proportion of patients living with mental health illnesses have experienced a traumatic experience across their lifespan and that trauma has far-reaching impacts on an individual’s life (Grossman et al., 2021). Trauma-informed care seeks to identify the manifestations of trauma in staff, patients, and families, incorporate knowledge about trauma into practices, policy-making processes, and procedures, and understand the paths to the recovery of patients with a history of trauma (Grossman et al., 2021). Trauma-informed care has the potential to improve treatment adherence for patients with mental health illnesses, improve patient-caregiver engagements, improve provider and staff wellness, and improve the health and clinical outcomes of patients with mental health illnesses. This highlights the significance of this approach.

Long-term effects of Adverse Childhood Experiences

Adverse childhood experiences (ACEs) are an umbrella term used to define all potentially traumatic events occurring during childhood. They include physical and sexual abuse, neglect, discrimination, racism, and domestic and community violence, among others. Regardless of the form, adverse childhood events have profound long-term effects. ACEs have a negative effect on the psychological, behavioral, and health outcomes of the affected children. Webster (2022) notes that the effects of ACEs are far-reaching, with many people who experience adverse childhood events proceeding to develop mental health illnesses such as major depressive disorder, chronic physical illnesses such as asthma and COPD, and substance abuse disorders, among others, during adulthood. Persons who experience ACEs are also more likely to be obese or overweight and subsequently develop cardiovascular illnesses. The correlation between these illnesses and ACEs is significant, with children who experience more severe ACEs having higher chances of developing psychological and behavioral problems (Webster, 2022). This highlights the need to address ACEs.

Methods for Building Resilience

Building resilience among children who have experienced trauma remains integral to their health promotion and preservation. Several strategies can be used to build strength and resilience among children who have experienced ACEs to help prevent negative health outcomes in the future. Maintaining physical and emotional availability to children who have experienced trauma may significantly build their strength and resilience. This can be attained by providing attention, encouragement, and comfort in a manner the child accepts, responds to, and follows their lead. Maintaining availability may foster a sense of belonging to the child, allowing them to recover and further minimize their chances of having poor health outcomes later in adulthood (Amin et al., 2020).

Encouraging high self-esteem can also help the child build their strength and resilience. This can be attained by praising their efforts, encouraging them, fostering meaningful and healthy relationships, and focusing on their strengths. Encouraging self-esteem in children who have experienced ACEs inculcates a positive sense of self-worth in the children. This may help in minimizing their chances of developing poor health outcomes in adulthood (Amin et al., 2020).

Additionally, allowing the child to have some control over their lives can also help in building resilience and strength among children who have experienced trauma. This can be attained by allowing them to make age-appropriate choices and avoiding unnecessary interference in their decisions. Allowing the child some level of control in their life may enable them to develop a sense of meaning. It may also allow them to believe in their ability to be successful in diverse areas of life. This may further diminish their chances of developing poor health outcomes in adulthood (Amin et al., 2020).

Integration into Practice

The PMHNP program is a gateway into professional mental healthcare. Trauma-informed care tailors care processes on patients with mental health illnesses towards interrogating past traumas that may be interplaying in the development of their current presentations. These provisions can be integrated into PMHNP practice through a broad framework that starts with the recognition that the impact of trauma is far-reaching and that a significant proportion of patients presenting with mental health illnesses have a history of early childhood trauma. In this respect, all patients should be handled uniquely to facilitate the identification of any potential traumatic events that may be contributing to their current presentation.

Another way to integrate the provisions of trauma-informed care is to be proactive in advocating against child violence, neglect and abuse, and any other potential source of trauma. This can be attained through structural education so that parents can enhance their accountability in child care. PMHNPs, as nurse advocators, can work with other lobby groups to create a safe environment for children. Working with children and parents is building resilience and strength among children with histories of trauma can also be key. This will go a long way in minimizing the chances of the already affected children developing various psychological and behavioral problems.

References

Amin, R., Nadeem, E., Iqbal, K., Asadullah, M. A., & Hussain, B. (2020). Support for students exposed to trauma (SSET) program: An approach for building resilience and social support among flood-impacted children. School Mental Health, 12(3), 493–506. https://doi.org/10.1007/s12310-020-09373-y

Grossman, S., Cooper, Z., Buxton, H., Hendrickson, S., Lewis-O’Connor, A., Stevens, J., Wong, L.-Y., & Bonne, S. (2021). Trauma-informed care: Recognizing and resisting re-traumatization in health care. Trauma Surgery & Acute Care Open, 6(1). https://doi.org/10.1136/tsaco-2021-000815

Webster, E. M. (2022). The impact of adverse childhood experiences on health and development in young children. Global Pediatric Health, 9. https://doi.org/10.1177/

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1. What is Trauma-informed Care?
2. What can be some of the effects of adverse childhood experiences (ACEs) on psychological,
behavioral, and health outcomes.

The Impact of Trauma and Adverse Childhood Experiences (ACEs) on Mental Health and Well-Being

3. Patients with a history of adverse childhood experiences are at risk of developing negative
psychological, behavioral, and health outcomes. Identify at least three methods to build and
strengthen a child’s resilience and help lessen the consequences of ACEs.
4. How do you see yourself integrating trauma-informed care into your practice as a PMHNP?