Town Hall Meeting on ACES (in Holland)

On April 15, we held our first Town Hall Meeting in Holland at the Butternut Event Center, regarding Adverse Childhood Experiences, or ACES.

-Leigh Moerdyke (Arbor Circle/SCAN)
-Marcia Mansaray (Dept. of Public Health)
-Jodi Spicer (Michigan DHS)
-Donna Lowry (Ready for School)
-Ria Neiboer (Pine Rest Holland Clinic)
-Ann Heerde (CMH Program Supervisor)

-Zeeland Community Hospital
-Pine Rest
-Ottawa County
-Holland pub
-West Ottawa
-City of Holland

-Just Goods
-Macatawa Bank
-Holland Carey and Sweets

53% of people in Ottawa County have at least 1 ACE, while 14% have 4 or more ACEs.


 Need to connect resources to help build strong childhood

 There was a study completed that included 17,000 people, average age 57, individuals had HMO insurance, middle income, Caucasian

o Found the impact of ACES does impact us over the lifespan, every time we have an ACE the impact increases, more than ½ of participants had at least 1 ACE, an increased ACE score correlates with higher likelihood of poorer adult health and wellbeing outcomes, research shows that when protective factors are in place they make meaningful differences, as your ACE score increases risk for smoking, addiction, etc.

 ACES include: Physical abuse, emotional abuse, sexual, physical neglect, emotional neglect, mental illness, incarcerated relative, witnesses domestic violence, substance abuse, divorce

 5/10 individuals deal with childhood neglect (under the age of 4)

 If a child has experienced childhood abuse, they usually have more than the 1 ACE

 High amounts of stress, increases cortisol and doesn’t allow the brain to develop correctly

 Long term cortisol leads to other effects

 Unpredictable, severe, prolonged and vulnerable stress that impacts brain development

 Life expectancy reduces by 20 years with 4 or more ACE

 Reduces economic success by 1 billion dollars

 ACEs are common, more recognized, strong predictors of later health outcomes, interrelated,

 What do we do: prevent, mitigate, treat

Marcia- ACE’s in Ottawa County

 Community Health Needs Assessment- used to identify key problems and assets to develop strategies to address our health needs and identified issues

 1300 adults, 11 questions, developed by CDC (abuse in the home, chaotic environment)

 Emotional Abuse 31% in childhood

 25% reported separated or divorced parents

 Ottawa county was same or worse than Michigan- household mental illness and incarcerated member

 4 or more ACE’s is the tipping point, 14% Ottawa county, 15% Michigan, 14% US

 More people in Ottawa County reporting 0 ACES so there is a gap with understanding

 Less likely to have an ACE score: college grads, 65 and older, 75,000 or more

 Common Health Outcomes:

o Obesity affects 1 out of 4 people, 40% with 4 or more Aces are likely to be obese

o Chronic pain- 0 Aces 19%, 50% of people with 4 or more ACEs report chronic pain

o Disability- 41% with 4 or more aces

o Smoking- 7% to 49% with 4 or more aces

o Heavy drinker- 3% to

o Suicide attempt- 0% with 1 ace score, 50% with 4 or more aces

 “It’s easier to build strong children than to repair broken men” Frederick Douglass

Jodi Spicer- State responding to ACE’s

 ACES are common

 Annual telephone survey completed with 12,000 people in Michigan via landline and cell phone. They asked the ACES questions of about 3000 residents.

o Highest ACE was verbal abuse, 2nd was living with substance abuse

o Prevalence- 18.2% of adults had 4 of more ACES

o Data has served as a catalyst and connector at state level to begin to understand that we need to change the way we think about ACES/trauma

o NEAR (neuroscience, epigenetics, aces and resilience)

o Master trainer- 106 in Michigan

o User friendly information tools- Movie “Resilience” ted talk

o 2019- will be asking ACE questions

Donna Lowry- How physicians are using the data

 How children succeed- 3 chapters talked about ACES

 Ready for School was convened by the Community Foundation in 2008 as an entity that could look at data

 Health care providers are learning and understanding the data

 Integrated with social work, care management and referrals

 In 2009 only 43% of children are ready for school, now at 66%

 ACES cause over stimulation in our brains, creates a learned response of our physiology to not turn off, substances in the blood damage our body, the body parts that get the most blood flow are most affected, chronic stress response

 Any place that providers can mitigate the stress responses (toxic stress), relationships help mitigate the emotional response to stress

 Reach out and read- health care providers are presenting a book, conversation about brain development, concerns about your child, spur health care provider to get information on child development

 Nadine Burke Harris- integrative heath model, center of youth and wellness, 2 generation approach to ACES, primary care and integrative model, team of practitioners who are trained in trauma informed care are working together

Ria Neiboer- Treatment Modalities

 Trauma- something that happens once or over time and multiple things may happen over time, unsafe, unpredictable, clips are sense of safety…..

 Kids often blame themselves, they are hurt by every day stuff, parents need to ask the question

 You can be a safe person (don’t need to provide treatment)

 Find a therapist who doesn’t over medicate but finds the underlying problem

 Adolescents- are often seen as the problem causer, they need time to grow up, need patience

 Relationships are number 1

 Trauma treatment is holistic

 Yoga- mindfulness, breathing

 Evidence based therapy at Pine Rest

Ann Heerde- Resiliency

 Resilience- Ability of a strained body to recover its size and shape after being exposed to comprehensive stress

 “Suck it up” “pull yourself up with your boot straps” Not using phrases with trauma or stress

 Ability to return to being healthy and hopeful after bad things like trauma or ACES happen

 Safety (emotional and physical) and security, sensitive to everyone’s trauma, everyone experiences safety and security in a different way

 Impact of 1 positive adult relationship in the child’s life

 Who is a nurturing relationship for you and who can you be a nurturing relationship for

 Everyone is different- card club, book club, faith community, etc. people need to experience connectedness

 Skill Development- do we have the ability to cope with stress, coping mechanisms

 Communication skills- how do we develop communications skills, making sure that people with ACES have the ability to communicate

 We need to be able to say I need this or I want this

 Parents developing resilience for children and for themselves (handout)

 Resilience survey (relationships, internal beliefs, initiative, hobbies, able to say no, self-control)

 Recognize the ability to do self-care physical, psychological, emotional, spiritual, workplace/professional (hand out)

 Resilience Building Plan worksheet- self reflecting, strengthening relaxation techniques (hand out)

Q & A

 Grandchild with PTSD- treatable, brain disconnects, center ourselves to calm the brain down,

 Statistics- low amount of ACE’s for 65 and older Generational approach

o 2 or more people to count on- not as much today

o Community reciprocity- not as common today as it was in previous

o Overall feeling of self and hope- several reasons on why

 Great book-“Lost Connections” Why have we had an increase in depression/anxiety?

 Child with mental illnesses and there is only 1 social worker for the high school and middle school reach out to senators/legislators, they fund community mental health, Medicaid health plans, commercial insurance, unfortunately insurance needs a diagnosis, advocating to legislators for funding, statistic- there is ½ of the number of mental health professionals that there should be, community conversations, master trainer- train community champions (train people to share this message) individual level- power of 1, need to be the positive person, we need to be the person to help people who are struggling, most connected and most lonely generation right now,

 As a resilient adult that does not have children in school, what can we do to support teachers/educators?  Be that 1 person, mentor, support, faith based (prayer partner),

 Foster Care and adoption CMH have a lot of children who come from adoption/foster care and they look for trauma upfront, going to treat and work with the trauma and support the caretakers, talking with foster care agencies, making sure they know what resources are out there, Arbor Circle- foster care changes, strict caseloads, significant to place children with relatives, always looking for foster homes

Christa- ISD Behavior Consultant

 Mental health shortage in the schools, money coming from the state and they are trying to figure out the best way to use the money, how can we support all of our students, trauma informed schools committee

 focusing on 3 subcommittees:

o prevention- community

o practices- supportive strategies

o Compassion Fatigue- supporting teachers who are struggling with the teachers, administrators to build the school culture, supporting educators

 Mileages- keep supporting

Small Group Conversation

1. How familiar were you with ACE’s before tonight’s Town Hall Meeting?

2. What have you learned tonight?

3. How does knowing about ACE’s help?

a. Physical connection, mental health connection, impacts

b. When you know better you do better, raising awareness of ACES, systems of support, not doing it alone

c. When we know more we can prevent it

d. Common understanding and language, scientifically based, more control in the situation, once you know better you can change the future

e. More kids in the classrooms have trauma and there is a general feeling from the outside community that those kids (with trauma) are allowed in the classroom, other parents don’t know or understand why “those” kids are acting in ways and they don’t know that they have been truly hurt and going through a crisis, other children in school are learning empathy and acceptance (parents look at it in a negative way)

f. What’s happened to that person, don’t judge the person, how can I support this person instead of judging them

g. Community conversation are so helpful

4. How do we get this information to more people?

a. Church Sermon Series- Replace a sermon with ACE’s training

b. High school- awareness in schools, sports coaches, information on bathroom doors

c. User friendly information tools- get the message in the hand of parents

d. Information in your sphere of influence

e. Normalize conversation

f. Community Champion Training- Jodi is able to train for free

g. What happened vs. what’s wrong with you

h. Adults struggling with the ACE’s- normalize and have more conversation

i. Working with the library- Big Read

j. Resilience movie

k. Radio Stations- 89.3, 91.3, 99.3, JOI

l. Government, city council agenda/sponsor

m. Invite municipalities to events

n. School board meeting

o. Trauma informed resource spreadsheet- CMH working on

p. Churches- talk to a pastor

q. Not a one and done

r. Train medical staff

5. What else can you we do to address ACES in our community?

a. Employee newsletter, worksite wellness, HR

b. Physician screening one ACES

c. Home-school-doctor triad

d. Universal screening

e. Social opportunities for kids

f. Mentoring/Mentor Training (Kids Hop)

g. Paper Tigers movie (Netflix & Amazon Prime)

h. Mindfulness Training

i. Self-care

j. Youth ministries

k. Criminal justice system education

l. Pine Rest offer free workshops from Ria