How We Can Prevent and Address Adverse Childhood Events

The impact that mental health issues have on society, both in the U.S. and beyond, is coming to light. We know that approximately 1 in 5 adults in the U.S. – 43.8 million people – experience mental illness in a given year, leading to negative impacts that include poor health outcomes. And last week new research found that U.S. teens and young adults in 2017 were more likely to grapple with major depression and are more susceptible to suicide than their counterparts in previous generations.

As a leader in total health, Kaiser Permanente understands the importance of supporting the mental health and wellness of our members, the communities we serve, our employees and our physicians. We know that mental and physical health are closely connected, with each contributing to a person’s overall well-being. There is no total health without mental health.

Inside and outside of Kaiser Permanente, we talk and take action reconnecting the head to the body, which simply means to look at the whole person. In fact, at Kaiser Permanente, we have over 4 million specialty mental health and addiction medicine visits a year. We take a comprehensive approach to addressing mental health and wellness including creating new care models, building mental resiliency, reducing stigma and investing in medical research.

Our comprehensive approach for mental health and wellness includes work around addressing trauma and particularly adverse childhood experiences (ACEs). The pioneering, groundbreaking study conducted by Kaiser Permanente and the Centers for Disease Control and Prevention suggested that people who suffer childhood trauma – such as abuse, divorce, separation or the loss of a parent – are much more likely later in life to have chronic health problems and engage in risky behavior. For example, children with a high number of ACEs often struggle academically when they are young and are also more likely to have higher rates of alcoholism, obesity, cancer and diabetes later in life. The results of this study have since been validated in more than 1,500 peer-reviewed studies.

The study helped us all understand the impact of ACEs and made it clear we had important work ahead of us. The U.S. health care system faces significant challenges in addressing the need for mental health services including the complex health issues associated with trauma. Kaiser Permanente is responding by building a health care model that better integrates mental health services with primary care and community supports. Over the past four years, Kaiser Permanente has invested nearly $9 million to fund programs related to the prevention or treatment of trauma in children.

We also supported and partnered with the Prevention Institute to develop an Adverse Community Experiences and Resilience framework to understand community-level trauma. The framework has been broadly disseminated and as a result, has been adopted and implemented by more than 15 communities and embedded in statewide policy efforts in California.

And most recently, we invited our dedicated workforce to submit ideas on how to transform our approach to health and health care, and specifically asked how we can better help children who experience ACEs. We received thousands of responses and are now defining an approach that we believe can actually help mitigate and even prevent the health risks that arise as a result of ACEs. Through close partnership with local communities, we are going to create a system for developing, prototyping and scaling evidence-based solutions. Our system will identify effective programs and interventions based upon childhood development – starting at birth – or even pre-conception – through early childhood and into school age.

This work will complement our efforts with Thriving Schools, a comprehensive effort to create a culture of health and wellness for students, staff and teachers in K-12 schools and to help schools become more aware of the possible impact of trauma, promote student and staff resilience, and connect schools to clinical and community-based resources.

At Kaiser Permanente, we will continue to challenge ourselves to expand our mental health and wellness approach. It will take a village – from clinicians, families, schools, communities to businesses – to create new paths forward. As an organization, we are committed to improving the physical and mental health for all and are looking for others to join us.