Save Public Sector Services and Save Lives

Good morning

I am writing to you today, as we really have an opportunity to make a difference to the future of public sector services. Research over and over again demonstrates that homelessness, self-neglect, substance misuse and self-harm / suicide are symptoms or coping strategies presented as a result of abuse, neglect, bereavement and trauma. Every year billions of pound are given to services who will never succeed in their quest to treat a symptom / behaviour without treating the cause and so this money, time and effort is wasted.

The trauma needs to be addressed in order that the symptoms or coping strategies are no longer required by the person. To achieve this we require services to be ‘Trauma Informed’ and to understand the impact of ‘Adverse Childhood Experiences’ (ACEs). Mental health services that create preventative treatment at the time of the trauma, abuse, neglect or bereavement would ensure that the impact of trauma on the person does not escalate causing increased mental health and physical health problems, increased criminal activity and increased service costs due to bed blocking, damaged property and crisis driven services. Safeguarding children and adults and preventing the need for future services means addressing the trauma as well as the risks.

Public money needs to be directed toward preventing the escalation of the trauma and therefore the escalation of services required when the person reaches crisis. The increasing demand for mental health services could be alleviated:

• Research has consistently found that people using mental health services have experienced high rates of trauma in childhood or adulthood (e.g. Kessler 2010)
• and that these rates are higher than in the general population (e.g. Mauritz 2013)
• It has also been found that people using mental health services are more likely to have experienced violence or trauma in the previous year than the general population (e.g. Khalifeh 2015)
• Trauma influences physical, mental and emotional health as adults and can shorten life expectancy (e.g. Felitti 1998)
• Traumatic effects are cumulative: the more traumatic experiences a person is exposed to, the greater the impact on mental and physical health (e.g. Shevlin 2008)
• ′Furthermore, having a trauma history is associated with poorer outcomes for survivors, including a greater likelihood of attempting suicide, of self-harming, longer and more frequent hospital admissions and higher levels of prescribed medication (e.g. Read 2007; Mauritz 2013)

Trauma is costly in both human and economic terms:

• ′Economic costs include those from lost employment, presenteeism (being at work, but not functioning well), reduced productivity and the provision of mental health and other services (e.g. McCrone 2008).

But the real impact is on people and society.

• Trauma creates increased criminal activity, increased mental and physical health problems, increased substance misuse, increased self-harm or self-neglect, increased use of fire services (Hoarding), bed blockages as the person is unable to return home, rotating door of hospital and community responses that do not work unless trauma is addressed
• Trauma not only affects individuals in the present, but crosses generations socially, psychologically and, recent evidence suggests, epigenetically (e.g. Yehuda 2016).

Scotland have already began these initiatives:

https://www.gov.scot/publications/adverse-childhood-experiences/

https://www.nes.scot.nhs.uk/media/3971582/nationaltraumatrainingframework.pdf

https://www.scotland.police.uk/whats-happening/Trauma-Informed-Policing

https://www.nhsggc.org.uk/your-health/health-services/glasgow-psychological-trauma-service/

https://www.scottishrecovery.net/addressing-adverse-childhood-experiences-in-scotland/

https://www.nes.scot.nhs.uk/education-and-training/by-discipline/psychology/multiprofessional-psychology/national-trauma-training-framework.aspx

 Wales also have some childrens initiatives:

https://www.wales.nhs.uk/sitesplus/888/page/88524

https://www.aces.me.uk/in-wales/

Statistics regarding the number of people affected by trauma are startling:

• A woman’s experience of trauma impacts every area of functioning, including physical, mental, behavioral, and social.
• 55 percent to 99 percent of women in substance use treatment and 85 percent to 95 percent of women in the public mental health system report a history of trauma, with the abuse most commonly having occurred in childhood.
• The Adverse Childhood Experiences (ACE) study conducted by the U.S. Centers for Disease Control and Prevention and Kaiser Permanente assessed associations between childhood trauma, stress, and maltreatment and health and well-being later in life.
• Almost two-thirds of the participants (both men and women) reported at least one childhood experience of physical or sexual abuse, neglect, or family dysfunction, and more than one of five reported three or more such experiences. https://www.psychologytoday.com/gb/blog/modern-day-slavery/201707/trauma-informed-care-and-why-it-matters

It has recently been suggested that children have been misdiagnosed with Attention Deficit Disorder (ADHD)because services have not recognised the possibility that a person affected by trauma can present similar responses to those expected when a person has ADHD. The statistics demonstrate the huge increase in diagnosis:

• In 2011, the CDC reported that the prevalence of attention-deficit/hyperactivity disorder in children ages 4 to 17 years was 11%, with 6.4 million children diagnosed with ADHD and 4.2 million taking psychostimulants
• A dramatic increase from more than 30 years ago, when the rate of attention-deficit/hyperactivity disorder (ADHD) was estimated at between 3% and 5%.2 What is more concerning is that the prevalence of ADHD increased by about 35% just from 2003 to 2011, and there is no indication that this increase leveling out.1 More than 20% of high school-aged boys have been told they have ADHD!

Last year 112,070 people declared themselves as homeless and the number of people sleeping rough grew by 75% to 6,437. The links between homelessness and trauma are well known by practitioners in the field however, politically it is largely ignored.

and yet the costs continue to rise:

All safeguarding matters need to address trauma. Here are a few internet searches identifying the well known links:

Please if you want to save the future of our public services use the information in this post to lobby Matt Hancock the Health and Social Care Minister and your local representative. We need to stop blaming people and retraumatising them by calling them problematic, dirty and layabouts. We are replicating the behaviours of their abusers. We need to help them in a sensitive and kind manner to understand that the abuse was not their fault and that we can help them address the impact of the abuse. It will only take a few minutes to share this post and copy / paste the information to send to the Government. It costs nothing and could make a huge difference.