PITTSFIELD >> What serious topic can bring more than 200 people together for two and a half hours on a weeknight?
It's something that has major effects on health an life expectancy, but is not routinely screened or treated by physicians. It's something that anyone can encounter at any point in their lives. And it's something that can affect the quality of living for an individual and a community.
In a word, it's trauma.
On Oct. 5, several community and state agencies together hosted a forum called, "Creating a Trauma-Informed Berkshire County: A Community Conversation," at The Colonial Theatre. Currently a clinical term, advocates for the approach of care and concern for community members say they hope to make it a more grassroots movement and commonly understood community-based practice.
The event attracted a wide range of attendees, from clergy to community members, therapists to teachers, state legislators and the district attorney, among many others.
What participants said best introduced the topic to them was the screening of a September 2014 "TEDMED" TED Talk by Dr. Nadine Burke Harris, an American pediatrician. Titled "How childhood trauma affects health across a lifetime," the talk has since been viewed more than 2.3 million times on the TED website alone.
"OK," said Burke Harris in her video talk. "What kind of trauma am I talking about here? I'm not talking about failing a test or losing a basketball game. I am talking about threats that are so severe or pervasive that they literally get under our skin and change our physiology: things like abuse or neglect, or growing up with a parent who struggles with mental illness or substance dependence."
Various speakers took the stage to discuss this in various ways, including Julie Schwager, the new western region director for the Massachusetts Department of Mental Health (DMH); Chris Haley, director of the DMH's Berkshire Case Management Site; Kate Maguire, artistic director and CEO of Berkshire Theatre Group and chair of the Downtown Pittsfield Inc. Strategy 1 Task Force; and Dr. Alex Sabo, chairman and program director of the Department of Psychiatry and Behavioral Sciences for Berkshire Health Systems.
Appearing to resonate most with the audience at the podium were Colleen Sondrini, recovery services coordinator of the Brien Center, and Alan Vreeland of the Western Massachusetts Recovery Learning Community, who were invited to share their personal stories of how their lives have been affected by trauma.
Sondrini introduced herself as a "mother, grandparent, sober person, activist and survivor of trauma and abuse." Because of her past experiences, Sondrini said she became distrusting of others, isolated herself and felt ashamed. She said coping with the use of alcohol was not something she planned, and "it was never my intention to hurt myself or others" through her subsequent behaviors. Ultimately, she did find a 12-step program where she began to find people she could trust — because, she said, they didn't judge her — and who instead helped her change her habits.
"My life has been changed by the power of possibility, which has allowed me to move beyond suspicion and bias," said Sondrini, who went on to earn an award for her advocacy in helping peers connect with addiction treatment and services.
Vreeland described growing up in a household that was part of a strict "community," where things like Christmas and birthdays weren't celebrated, he lived in a rundown apartment, and socialization mostly took place in meetings of that community. Because of his behaviors, such as refraining from taking part in school holiday parties, he was shunned and beat up and teased by classmates and "I was labeled as 'a problem' by my teachers," he said.
That label, said Vreeland, followed him through adolescence into adulthood, prompted him to think about ending his life, and made it hard to reach out for help. When he did, he said he spent "two years in a box" and that being "labelled with a mental illness" meant that his life was over at age 20.
Vreeland, Sondrini, and forum presenters all said the commonality into feeling better and taking healthy steps to do so came from when people asked them "what happened to you?" versus "what's wrong with you?"
Instead of being bombarded with judging questions, Vreeland said he was met with "just compassion and curiosity" by his peers and others he encountered when he transitioned into the Western Massachusetts Recovery Learning Community. He said being treated this way worked better for him than any medicine he was being prescribed.
"Now, I'm volunteering and getting a job, and my life is beginning again," said Vreeland, who earned a standing ovation.
"It's about translating [this idea] into actions by the police department, the hospitals and schools," said Emmanuel Bile, who recently earned his master's of social work and serves on a DMH advisory board. "For example, what if you had a social worker ride with the police to a domestic situation. Instead of just putting it into the criminal system, they could begin to make referrals and address the bigger issues," he said.
Health care professionals like Dr. Sabo and emcee Jenifer Urff, director of recovery for the Western Massachusetts region of DMH, said that blending the neuroscience and anecdotal outcomes like Vreeland and Sondrini have experienced should be used to better coach communities to re-thinking how to approach people who may face various socioeconomic and health issues.
The science behind the correlation between trauma, health and well being is highlighted in an often referred body of research known as the Adverse Childhood Experiences (ACE) Study, published by the Centers for Disease Control and Prevention and Kaiser Permanente. At the time of the study, which took place between 1995 and 1997, it was revealed that 67 percent of the population had at least one adverse childhood experience, or ACE, and that one in eight people had four or more ACEs.
According to the state Department of Mental Health, ACEs can be caused by non-abusive situations, including family and household challenges like poverty and economic hardship or a health crisis.
As Dr. Nadine Burke Harris pointed out in her TED Talk, the CDC-Kaiser Permanente study showed that the higher your ACE score, the worse your health outcomes and including rates for risky behavior and morbidity. Trauma also doesn't discriminate by demographic; the original study population was 70 percent Caucasian, 70 percent college-educated, she said.
Because of this, the state DMH, through the federal Substance Abuse and Mental Health Services Administration (SAMHSA), has been working with municipalities to host "Community Conversations," tailored to the interests and needs of the host community.
Chris Haley, director of the DMH's Berkshire Case Management Site, said that to have a local Community Conversation around the topic of trauma is relevant to the region's issues of drug addiction and distribution, crime, violence and demand for mental health care and treatments.
Starting this week, the organizers and DMH staff involved in the "Creating a Trauma-Informed Berkshire County" movement will be meeting to go over feedback from the Community Conversation, including the suggestions and experiences that were shared during small group discussions about the issues the Berkshire community faces, what's working and what needs to change.
"This is a start," Haley said, "but change won't happen overnight. In some communities, it's taken a decade."
She referenced two U.S. cities that practice a trauma-informed approach: Tarpon Springs, Fla., and Walla Walla, Wash.
In Tarpon Springs, for example, staff members at a local elementary school are asking different questions about why students are have difficulty learning, become frustrated and often disrupt classrooms. Instead of being disciplined, children are getting hearing and vision exams and new eyeglasses when needed; a weekend snacks and meals program; access to a school uniform bank (with the support of a local church), and transportation to extracurricular activities where there's need.
In Walla Walla, the Children's Resilience Initiative brings together an intensive, structured collaboration with more than 30 community partners, including schools, city government, health and social services, law enforcement, justice, business leaders, the media and parents. Efforts to establish the CRI began in 2007. In addition to the direct neighborhood revitalization efforts, indirect results include seeing a local high school reduce its suspension rate by 85 percent in 2012.
Julie Schwager, the new western regional director for the Massachusetts Department of Mental Health, said the fact that 200 people turned out on a weeknight to learn more about what it means to have a trauma-informed community speaks volumes about the Berkshires and its readiness for change.
"It's clear to me the community really cares about these issues people face and wants to make things better," she said.