Philanthropy to Support Trauma-Informed Care: Harnessing resilience to overcome adverse childhood experiences
By Anne N. Connor, Director, Community Grants
One of Methodist Healthcare Ministries’ main focuses moving forward is to support resilient families. According to the Buncombe ACE Learning Collaborative, resilience is the ability to adapt well, or “bounce back” in response to difficult life events. When families experience hard things and stressors, says Buncombe, they need good experiences and resources to help balance the scale. That’s where trauma-informed care comes in.
First, some definitions:
- What are ACEs? ACEs are Adverse Childhood Experiences, traumatic events that disrupt a child’s healthy development and change the way their brains and bodies respond to stress. ACEs may include abuse, neglect, exposure to mental illness and addiction, and witnessing violence at home or in the community. ACEs are common! Some 60 percent of adults report having at least one ACE in their history and 25 percent of adults report experiencing three or more ACEs.
- What is Trauma-Informed Care? Trauma-Informed Care, or TIC, is an approach that understands and recognizes the role of trauma. TIC practitioners ask the client, “What happened to you?” instead of “What’s wrong with you?” TIC is focused on creating a safe, trusted environment that will not re-traumatize people. It is focused on helping ACE survivors build resilience and develop coping strategies.
Why does Methodist Healthcare Ministries care about ACEs? ACEs are an underlying cause of many painful, destructive and expensive health problems. They are associated with struggling, rather than thriving. Families cannot be resilient if caught in a cycle of trauma. Communities cannot thrive if families are suffering. If we could help people unpack their ACEs baggage and become more resilient, they could live happier, healthier lives.
Negative health outcomes associated with ACES can last throughout the life span. The more ACEs somebody experienced as a child, the higher their risk of various co-morbidities throughout their adult lives. Four or more ACEs are associated with: A twelvefold risk of suicide attempts; an eigthfold risk of alcoholism; a fivefold risk of chronic depression. But it’s not limited to behavioral health issues. There’s also a fivefold risk of perpetuating domestic violence, a fourfold risk of COPD, a twofold risk of any cancer, a twofold risk of heart attack or stroke and at least a twofold risk of obesity. ACEs are also tied to risk for general life dissatisfaction; approximately 67 percent of life dissatisfaction in the U.S. population is probably attributable to ACEs.
The link between ACEs and health problems was originally discovered by a physician in a weight-loss clinic, trying to figure out why patients who seemed to be doing well on BMI reduction suddenly started regaining their weight. His follow-up study found that emotional abuse was a strong predictor of obesity. Frequent verbal abuse increased the risk of having a BMI of 40+ by 88 percent. Frequent physical abuse increased that risk by 71 percent and sexual abuse increased it by 42 percent.
How is Methodist Healthcare Ministries philanthropically involved in trauma-informed care? Methodist Healthcare Ministries' community grants team has been involved in the ACEs/TIC approach since 2018, inspired by an internal screening of the film, Resilience. Our philanthropic involvement focuses on three initiatives:
1. South Texas Trauma-Informed Care Consortium and setting standards: The Consortium celebrated its one-year anniversary in September 2019.
- Methodist Healthcare Ministries is actively involved in the Consortium, and making a grant, to help set standards for TIC. The Consortium is a cross-sector collaboration, with 12 workgroups and over 100 organizations represented. Dr. Edward Dick (senior vp of integrated health services) and Anne Connor (director of community grants) both serve on the steering committee and are co-chairs of different workgroups. Chris Yanas (director of governmental affairs) serves on the workgroup focused on communication and advocacy.
- The Philanthropy Workgroup created guiding principles for trauma-informed funding, which include “Don’t fund programs that will re-traumatize people.”
- It became apparent to the entire consortium that standards and training are needed to transform TIC from a buzzword to a reality. In response, the Consortium is working to create a unique and powerful solution that addresses teh need in Texas.
2. Texas Association of Community Health Centers (TACHC) and Transforming FQHCs: Methodist Healthcare Ministries helped to facilitate funding for a huge opportunity for system change.
- TACHC launched an initiative in 2019 to start converting all FQHCs (Federally Qualified Health Centers) in Texas to Trauma-Informed Care Centers. The program involves multiple, in-depth, ongoing activities such as training, podcasts linking ACES to current events, and peer meetings, to engage each cohort of community health centers. The program uses PDSA-like “decision points” to review and improve the program before starting each new cohort. The goal is to treat TIC as a “universal precaution,” assuming that every patient who walks in has probably experienced some level of ACEs. FQHCs will create an atmosphere of trust and caring, from front-desk staff to medical providers.
- Methodist Healthcare Ministries is a voting member of the Texas Behavioral Health Funders’ Collaborative (TBHFC). TACHC received a $100,000 grant for 2019 and another $100,000 grant for 2020, from TBHFC, for this TIC transformation project. Both grants were initiated by requests from Methodist Healthcare Ministries, leveraging the organization’s membership dues in TBHFC 4:1.
3. Building Funder Awareness: The more funders who understand ACEs and TIC, the more support there will be for programs that build resilience.
- Anne Connor serves as one of the co-chairs of the Philanthropy Workgroup of the South Texas Trauma-Informed Care Consortium, and is actively recruiting additional grantmakers to this workgroup.
- She also serves on the planning committee of the San Antonio Area Funders’ Group. She was instrumental in bringing the 45-minute film about ACES, Resilience, to a screening for about 40 grant funders at the February 2019 meeting of the Funders’ Group.
Resilient Families: Methodist Healthcare Ministries aims to create the conditions in which families in our service area can be resilient, contributing to thriving communities and moving toward health equity. Trauma-Informed Care is a critical part of that effort.