Commissioning to heal trauma

Intergenerational and childhood trauma are root causes for adverse health and social conditions including lung disease, heart disease, mental illness, suicide, teenage pregnancies, homelessness, and addiction. The evidence linking trauma to health and social outcomes has been growing since the CDC-Kaiser ACE Study in the late 1990s.

We know trauma can be passed down through generations and that children experience neglect, abuse and/or grow up in a dysfunctional environment are much more likely to experience chronic health and social problems leading to shorter life expectancies. We also know that healing trauma is a highly impactful strategy in improving the wellbeing of communities.

In Australia, the communities most likely to be experiencing the consequences of trauma are Aboriginal and Torres Strait Islanders, refugees and people living in low socio-economic areas. The population data backs this up. We just have to look at the rates of chronic disease, suicide, out of home care, domestic violence, teenage pregnancies and addiction to confirm this fact.

...the communities most likely to be experiencing the consequences of trauma are Aboriginal and Torres Strait Islanders, refugees and people living in low socio-economic areas.

The current approach to commissioning is effective in adapting service provision for the needs of local communities but it is not designed to heal trauma. A new framework needs to be designed to improve health and social outcomes through healing.

The characteristics of the “Self-Healing Communities Model” implemented in Washington State provides some clues for a commissioning model within the Australian context. Key elements of that model are the focus on community and community leadership to focus on designing local solutions together. The concept of emergent learning and adaption to the changing local context seemed to contribute to their impressive results.

Trauma cannot be "fixed" through intervention. Trauma needs to be healed through empowerment, connection, and a sense of belonging. To achieve this, we need a grass roots movement supported by a whole of government scaffold to facilitate self-determined processes to heal. A paradigm-shift in policy, service design and funding are needed to begin the journey.

Trauma cannot be "fixed" through intervention.

We have an emerging body of resources to support this paradigm shift. The Politics of Trauma by Staci K. Haines is one of many thoughtful approaches to trauma healing. The opportunity cost of not embracing a new framework includes failing to close the gap. The fruits of a new paradigm shift may not be realised in our lifetime, for example the GenerationFIVE and the Fight Against Child Sexual Abuse program commits to ending child abuse in five generations.

But the reality is that trauma created over the generations will be healed over generations.

It will be a challenge to get support for long term strategies within a context of short term political cycles. But the reality is that trauma created over the generations will be healed over generations. However, it is possible to lay the foundation in the immediate term by building a commissioning framework designed specifically to support healing. ?

Do we have the courage to disrupt the current paradigm?