You’re hiking through a dense, remote forest. You spot a grizzly bear in the distance. Your heart pounds, muscles tense, and your brain kicks into high alert. This is our bodies reaction to danger, preparing us to respond to present threats. 

 

But what if the bear comes through your front door every night? What if you encounter the bear daily and this response is triggered over and over again? This is the case for some. Many children across California recurrently experience this chemical response from Adverse Childhood Experiences, or ACEs, that have a wear-and-tear effect on the body. 

 

In 2021, Former Surgeon General Nadine Burke Harris championed this issue, asserting that untreated ACEs are the greatest public health crisis facing California. According to Harris, addressing ACEs means reducing a myriad of health issues Americans face. 

 

Three years ago, California invested $4.7 billion in a kid’s behavioral initiative to address youth mental health issues. A portion of this investment is going towards preventing trauma and reducing the impacts of ACEs. This statewide push has taken strong root in Santa Barbara County, where public health officials, health care workers, and educators have created an extensive childhood resilience network. 

 

What are ACEs?

 

A growing body of research has shown that stress and trauma has life-long effects on children — even changing their biology like the function of their brain or immune system. More recently, CDC studies uncovered a direct correlation to heart disease, cancer, diabetes, and stroke. Most strikingly, kids that experience continuous adversity are 37 times more likely to attempt suicide. 

 

ACEs are highly stressful experiences that happen to children. They can be single events or ongoing struggles. According to the ACE Resource Network, there are 10 types of stressful or traumatic events that fall into three categories: abuse, neglect or household challenges. This ranges from having an alcoholic family member to experiencing divorce. 

 

ACE “scores” are determined by assessments in doctor’s offices, clinics, or online screenings.

 

Whitney Johnson, a senior at UCSB studying Psychology, has an ACE score of seven. Johnson and her younger sister’s upbringing was highly unstable. Her parents divorced when she was in middle school. For a period of her adolescence, Johnson’s mom was incarcerated and struggled with mental health and addiction. 

 

“I was 11 and my mom wouldn’t get out of bed for days. Sometimes we couldn’t even find her. I made lunches for my sister and got us to school,” Johnson said. 

 

According to Johnson, it’s hard to pinpoint how this takes effect down the road. “For the early years at college, I don’t think I understood the depth or impact growing up in that kind of environment had on me,” Johnson said. 

 

Johnson reflects on her underclassmen years and sees a correlation between her decisions and her experiences in childhood. “I didn’t realize it was even coping or my brain instinctually surviving, but I remember blacking out a lot and having control issues around stuff like food. I probably kept people at an arm's length because my instinct was to protect myself,” Johnson said. 

 

After starting therapy her junior year, over time she developed the skills to cope with the impacts of her upbringing. 

 

“I’ve learned a lot about what it means to be mentally resilient. It definitely helps to have learned some coping skills,” Johnson said. “I think it’s super important to make this available to kids because I know I’m definitely not alone.” 

 

Johnson is pursuing a career in therapy. She believes her experiences are empowering entering this field and give her the greater capacity to help others.  

 

The work in Santa Barbara 

 

Santa Barbara County initiated ACEs work five years before the historic investment from the state. In 2016, exposed to the research on childhood adversity, health care and social service providers in Santa Barbara started to explore the prevalence of ACEs on a community level. 

 

First, the SB Department of Social Services created the KIDS Network. The issue of childhood adversity and mental health is approached from varying sources and organizations. So, the county created KIDS Network to serve as a hub for agencies and citizens it serves. The network connects over 20 groups that support children like neighborhood clinics, Carpinteria Children’s Project, Family Service Agency, behavioral wellness centers and school districts. 

 

Children Network Director Barbara Finch and her colleagues started a conference to connect all the different actors that could be involved in a movement locally. 

 

Finch has worked in child and family law for over 30 years. For over a decade now, she has served as a senior director in Santa Barbara’s Department of Social Services. 

 

In their first year, the Bridge’s to Resilience Conference hosted 300 educators, social workers, health professionals, and community partners to network and establish a county-wide master plan on this issue. 

 

After the first successful conference, the county provided a grant to CALM, a nonprofit specializing in childhood trauma therapy and screening. 

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CALM partnered with UCSB to conduct a research project implementing tests for kids at Santa Barbara Neighborhood Clinics. During screenings, they identify patients who have or are at risk of experiencing abuse, neglect or adversity. The CALM worker and pediatrician direct families to the right support — whether it be therapy, postpartum support, addiction support, or referral to other community resources. The research project sought to answer whether this made a positive difference for the kids they screened. 

“The support we saw from community leaders is what officially started us pulling together as a strong and legitimate network,” Allison said. “It’s one thing to build the infrastructure, but what is key is for the right people to buy in.”

 

Soon after, Harris and Governor Newson implemented the nearly $5 billion behavioral health initiative, serving the first round of ‘ACEs Aware’ grants. 

 

SB County received three grants. The first was to continue the Bridges to Resilience Conference. 

 

The second was to replicate the initial resiliency project from CALM and UCSB on a larger scale. The county established the Pediatric Resiliency Collaborative, which basically expanded ACEs screenings to all children's clinics in the county. The grant also funded screenings for infants, toddlers, and even prenatal screenings. The third grant established the Network of Care which created a closed loop referral system, where patient data and referrals are done on one platform between varying agencies.  

 

SB Resilient Trauma-Informed Training and Care 

 

Allison started a program to integrate trauma informed training into the workforce. The goal is to educate on how trauma affects people, “shifting focus from what’s wrong with you to what happened to you?” Allison said. 

 

At the quarterly public conference for the statewide mental health initiative in January, Harris highlighted the significance of a compassionate workforce, especially in occupations that work with children. 

 

“The antidote to toxic stress is safe, stable and nurturing relationships and environments,” Harris said. “It takes one caring adult to be the difference for that child. So, whether the person is the custodian, a parent, a professional, a teacher, a counselor, we can each play a valuable role in supporting the students that we serve.”

 

Allison started with county jobs, educators, and healthcare work — instating trauma-informed care as a mandated part of orientation for these occupations in Santa Barbara. The training not only informs how to empathize with others, but it also provides a toolkit to cope with one’s own ACEs.  

 

Her goal is to have more organizations, beyond the education and healthcare sectors, to do this with their staff. 

 

As a mother of two, Allison’s experiences raising children inspired her to educate and provide support to others. She uses her story to show others that people are not defined by their experiences.  

 

Allison had a healthy childhood — she grew up in a household with no neglect or abuse. Her parents were happily married.

 

“I got married and thought I was going to have the white picket fence and all that. But my children each have an ACE score of five,” Allison said. 

 

“The first time I learned about ACEs and resilience, I cried. I thought, oh my gosh, I doomed my children to poor health and poor behavioral health outcomes.”

 

Allison uses her own story to highlight the power of positive experiences and developing a mental health toolkit. 

 

“I was the caring, consistent adult. I made sure that my kids had mentors. They had music teachers, scout leaders, sports teams, and all these other people in the community that just wrapped themselves around my kids when things were hard,” Allison said.

 

As a result, her children grew into healthy and highly successful adults despite their adverse experience. 

 

“The message from my kids being that if you have positive experiences and healthy relationships to balance out the adversity, you can actually come out better,” Allison said. 

 

Public Health Challenges

 

Despite the success stories coming out of Santa Barbara, ACEs are a difficult issue to tackle from a public health perspective.

 

According to Finch, the most difficult part of addressing this problem is the adverse community environments and social issues that it stems from. 

 

“We’re talking about poverty, discrimination, or community violence. We’re never going to eliminate those problems,” Finch said. 

 

Instead, the approach of the children’s mental health initiative is to equip people with the tools to cope with adversity.

 

“If people don't have enough food on the table or are facing really scary insecurities, they’ll often turn to drugs and alcohol. That's how people cope and why we see such high addiction rates in people who experienced a lot of ACEs.”

 

This is why a lot of the initiative directs energy into providing a toolkit for dealing with mental health problems. 

 

According to Finch, public opinion and the approach to working with children has undergone a considerable shift since she started this work in 2016. 

 

“Schools are becoming more trauma informed. Probation is becoming more trauma informed in their approach to juvenile justice,” Finch said. “The narrative is shifting in that people that do bad things aren’t inherently bad people. It really feels like a movement people are buying into.”