Government

Policy, Requirements, and Laws (Federal, State, County, and City)

Levers of Change: Actors

Mayors

City/County Elected Officials

State and Federal Elected Officials

League of Cities

Levers of Innovation: Actions

Quick Wins (QW) or Major Project (MP)

Universal

Require system sector training (lawyers, foster parents, child welfare, law enforcement, etc) in ACEs awareness and trauma-informed approaches (QW).

Conduct ROI assessment to determine the impact of services and their resulting savings (MP).

Selected

Provide incentives for behavioral health and therapeutic professional employment in preschools, at childcare providers, and within community programs (QW)

Indicated

Establish requirements for ACEs-aware and trauma-informed training (with required best practices) to receive funding (QW)

Call to Action:

The governmental sector needs a paradigm shift from reactive, punitive measures to address the effects and outcomes of ACEs, and adopt a preventative, early years investment approach with an accompanying ROI analysis. 34

The logical links between the investments and the health benefits reveal that for every 100 cases of child abuse society can expect to pay for in middle or old age (among a wide range of physical and mental health consequences): one additional case of liver disease, two additional cases of lung disease, six additional cases of serious heart disease, and 16% higher rate of anti-depressant prescriptions5 0

The estimated average lifetime cost per victim of nonfatal child maltreatment is $210,012 in 2010, including $32,648 in childhood health care costs; $10,530 in adult medical costs; $144,360 in productivity losses; $7,728 in child welfare costs; $6,747 in criminal justice costs; and $7,999 in special education costs. The estimated average lifetime cost per death is $1,272,900, including $14,100 in medical costs and $1,258,800 in productivity losses The total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the United States in 2008 is approximately $124 billion In sensitivity analysis, the total burden is estimated to be as large as $585 billion50

All related institutions, services, staff and personnel directly employed or reporting to the court and judicial system.

Levers of Change: Actors

15th Judicial Circuit

Baker Acts

Probation Officers

Guardian Ad Litem

Public Defenders

State Attorney Office

Levers of Innovation: Actions

Quick Wins (QW) or Major Project (MP)

Train workforce in ACEs and the intergenerational transmission of ACEs (QW)

Provide training on specific strategies to use within the context of court hearings (QW).

Consider the presence of intergenerational trauma during kinship placement, especially in sexual abuse cases (QW)

Prioritize cultural, age appropriate placements, and the continuity of therapeutic interventions, when possible (QW)

Mandate co-parenting couples be educated on ACEs and the effects of toxic stress on the developing brain, as well as the power of buffering and nurturing relationships (MP)

Call to Action:

The power of the justice system to respond and create a corrective course or a punitive, traumatized course for individuals is equally possible, powerful and with lasting implications for the individual and society in either direction. While there are certainly cases where incarceration are necessary, a challenge would be to see each case through a trauma informed lens Incarceration removes people from society, erodes work skills, weakens social networks and alters employer perceptions

There is opportunity at every decision making point to respond in a trauma-informed way:

Understanding and awareness that individuals chronically exposed to trauma are often hypervigilant and can be easily triggered into a defensive or aggressive response;

Identification of individuals with ACEs, and ensuring trauma is not driving entry, involvement into the juvenile and/or criminal justice systems;

Collaboration between systems that an individual might encounter; Preventing further trauma by responding in a way that reduces exposure to traumatic reminders and equips individuals with the supports and tools to cope with traumatic stress reactions;

Delivery of behavioral health services to address active trauma symptoms;

Utilizing procedural justice by focusing on fairness in the processes that resolve disputes rather than only fairness in the disputes’ outcomes.