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Policy

Adverse childhood experiences (ACEs) are correlated with later life mental health, substance abuse, health risk behaviors, and many serious health consequences, along with the associated high individual and societal costs.

The World Health Organization (WHO) has prioritized prevention of child maltreatment and supports addressing ACEs to improve public health as laid out in this 2009 meeting report. Providing recommendations for policymakers, this meeting report states: "To raise ACE awareness and bring these different sectors on board, a clear presentation that simply conveys the essence of the ACE concept, consequences and implications should be developed. Once this is available, participants would take every opportunity to deliver the presentation to their colleagues, peers and other potential interest groups" (p.9).

This website serves as a way to "link policymakers, program directors, practitioners, and researchers involved in the implementation and evaluation of ACE response strategies around the world" (p.10).

Thus, we hope to bring people together across sectors. While many policymakers, program directors, and practitioners recognize the relevance of ACEs to treatment and services in each of these areas, most human service agencies in the United States continue to operate as separate and distinct entities.

Discrete agencies provide substance abuse, mental health, health, homeless, and criminal justice services. People who are disadvantaged and experiencing multiple problems are challenged to navigate this fragmented service delivery system.

ACE research speaks to the need for professionals to work together and calls policymakers to transform our systems of care.

• ACE response can help meet national health goals outlined in Healthy People 2020.
• Recovery-oriented systems of care can play an important role in ACE response.
• The former Washington State Family Policy Council acted as a state level interagency council partnering with community public health and safety networks to support community-driven change in response to ACE knowledge. The notion of human capital development, or the production of abilities and skills, explains why preventing and addressing ACEs is profitable.

ACEs place a major economic burden on society.

• Confirmed cases of child maltreatment in a single year are associated with an estimated total of $124 billion in lifetime financial costs, according to a Centers for Disease Control and Prevention (CDC) report (you can find the CDC's full report here).  
• Intervention programs with disadvantaged children already demonstrate significant benefit-cost ratios with $5.70 for every dollar spent on a child by the time the child became an adult aged 27 and, when projected into the rest of their lives, $8.70 cost savings in crime reduction (see Schweinhart et al., 2011).
• Each new developmental stage begins with the skills gained in the previous stage.
• Costs of later investments are reduced by early investments in younger children.
• Families, Schools, and other systems play a strong role in human capital development.

By integrating knowledge of effective helping approaches with ACE research, we can point to cost-savings associated with ACE prevention and intervention across the lifespan. Identification of policy examples supportive of ACE response will guide policymakers seeking to save money by supporting ACE response.

Program evaluation can further demonstrate how comprehensive "ACE-informed" programming, designed to mobilize resilience and recovery, serves to defray costly ACE consequences and prevent ACE transmission to the next generation.The SOAR approach can be applied for the ongoing evaluation of ACE-informed programming.

Tools and Resources for Policy Advocacy

• Changing Legislation to Unite Brain Science and Policy - A video recording of a presentation given by Clare Anderson, former Deputy Commissioner of the Administration on Children, Youth, and Families, at the 2013 national Alliance for Children and Families conference. In the video, Anderson reveals how ACE data can be used to influence lasting policy change and reminds us to always "start with the data."

• Campaign for Trauma-Informed Policy and Practice - Grounded in NEAR science, CTIPP is a trauma-informed movement aiming to promote healing at all levels of society through political advocacy and cross-sector collaboration. 

• Child Traumatic Stress: What Every Policymaker Should Know - A thorough and easy-to-read guide developed by the National Child Traumatic Stress Network (NCTSN) to educate policymakers on childhood trauma, which is rightly introduced as a "critical policy issue." The guide reviews some effective trauma-informed practices, describes various ways in which policymakers can help build solutions, and lists additional resources to explore.

• Trauma-Informed Social Policy: A Conceptual Framework for Policy Analysis and Advocacy - Elizabeth A. Bowen, PhD, and Nadine Shaanta Murshid, PhD, from the University at Buffalo School of Social Work, propose a trauma-informed framework for social policy in this peer-reviewed article. Key principles of trauma-informed social policy laid out in the framework could prove helpful in guiding practitioners, researchers, and policymakers engaging in policy-level ACE response work.