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It is critical that people learn about the intersection of trauma, mental health challenges, and substance use and how they will impact women and girls and their families and communities and overall well-being. Representatives from more than three dozen federal agencies have gotten together to focus on this issue and to develop collective strategies to address its impact. This webinar held May 29, 2014 aimed to address: "the historical context of the intersection of mental health substance abuse and trauma; review current research of the problems of trauma and adverse experiences, and the impacts of that on women and girls; highlight two evidence-based practices of seeking safety in the trauma resolution center; and the core components of a trauma-informed approach when focusing on these intersections". The presentations given during this webinar are: "SAMHSA's Women and Violence Study Trauma Services in Public Mental Health [WCDVS]" by Susan Salasin; "Adverse Childhood Experiences: Impacts on Health & Wellbeing across the Life Course" by Melissa Merrick; "Seeking Safety: An Evidence-Based Model for Trauma and/or Addiction" by Lisa M. Najavits; and "If It Works in Miami…a Model Program for Serving Traumatized Human Beings" by Teresa Descilo.

Addressing the Intersection of Trauma, Mental Health Challenges, and Substance Use Cover

“Offenders are exposed to violence at higher rates than the general population. Whether exposure to violence contributes to subsequent maladjustment once these individuals are incarcerated, however, is unclear … Inmate maladjustment [the inability of inmates to cope with confinement] threatens the safety and order of correctional institutions, so a thorough understanding of the relative effects of exposure to different forms of violence on maladjustment is important to prison/correctional facility administrators. Using data from the Survey of Inmates in State and Federal Correctional Facilities and the Census of State and Federal Correctional Facilities, we examined the relationship between exposure to violence and maladjustment within and across state operated prisons and correctional facilities in the United States.” Results are presented for: analyses of exposure (direct and indirect) to violence and maladjustment; inmate-level effects on maladjustment; and the main and moderating facility-level effects on maladjustment. The exposure to violence an inmate experiences prior to incarceration increases that inmate’s level of maladjustment with little change across various types of correctional institutions.

Assessing the Relationship between Exposure to Violence and Inmate Maladjustment Within and Across State Correctional Facilities: Final Report Cover

This 7-page fact sheet delineates the path from complex trauma exposure to involvement in the juvenile justice system; describes the “survival-oriented coping” that youth adopt to manage their lives; and explores the many challenges these youth face in managing their emotions, physical responses, and impulses.

"Recognizing that most inmates are trauma survivors and many common prison routines can re-traumatize women, the Women’s Community Correctional Center of Hawaii, under the leadership of Warden Mark Kawika Patterson, works to create “a place of healing and forgiveness” [pu'uhonua] through its Trauma- Informed Care Initiative (TICI) … Reducing the use of restraints and isolation has been a focus of the training and activities of TICI, since these interventions are likely to re-traumatize women who are trauma survivors and cause trauma responses in women who had not previously experienced trauma" (p. 1). Sections of this publication include: program-at-a-glance; WCCC inmate demography; what trauma is; some potential sources of trauma; trauma's effects on individuals; the consequences of historical trauma; institutional practices can re-traumatize; healing from trauma; planning and implementing the WCCC Trauma-Informed Care Initiative—needs assessment, planning, training on trauma-informed care, and strategic planning; TICI accomplishments—trauma screening and assessment, workforce development, and the use of trauma-informed practices to reduce seclusion and restraint; resources to build the pu'uhonua; keys to success—inspirational leadership, becoming a learning organization, survival participation, community involvement, and partnering with other government agencies, academia, and community-based non-profits.

Creating A Place Of Healing and Forgiveness: The Trauma-Informed Care Initiative at the Women’s Community Correctional Center of Hawaii Cover

This publication describes the eight essential elements of a trauma-informed juvenile justice system. These elements are: Trauma-Informed Policies and Procedures; Identification/Screening of Youth Who Have Been Traumatized; Clinical Assessment/Intervention for Trauma-Impaired Youth; Trauma-Informed Programming and Staff Education; Prevention and Management of Secondary Traumatic Stress (STS); Trauma-informed Partnering with Youth and Families; Trauma-Informed Cross System Collaboration; and Trauma-Informed Approaches to Address Disparities and Diversity.

This study examines the effects of mental health screening and service delivery on perceived future criminal justice interactions— arrest and incarceration—among adjudicated youth … housed in correctional facilities … Significant relationships between traumatic events and mental health problems were found, along with relationships between mental health problems and mental health screening and service delivery. Most interestingly, results pointed to the strong inverse relationship between mental health service delivery and youth’s perceived likelihood for recidivism (p. 250).

"Children who come to the attention of the juvenile justice system are a challenging and underserved population. The National Child Traumatic Stress Network has developed resources to help juvenile justice professionals understand and provide trauma-focused services to these youth." This website has a wealth of information about trauma-informed juvenile justice. Access is provided to the "Current Issues and New Directions in Creating Trauma-Informed Juvenile Justice Systems, Brief Series": Trauma-Informed Juvenile Justice Roundtable--Current Issues and New Directions in Creating Trauma-Informed Juvenile Justice Systems; Trauma-Informed Assessment and Intervention; The Role of Family Engagement in Creating Trauma-Informed Juvenile Justice Systems; Cross-System Collaboration; Trauma and the Environment of Care in Juvenile Institutions; and Racial Disparities in the Juvenile Justice System--A Legacy of Trauma. Also available is the "Screening and Assessment in the Juvenile Justice System Speaker Series": The Use of Web-Based Screening for Trauma and Associated Disorders in Juvenile Justice Involved Youth; Utilizing Trauma Screening and Assessments in Court Decisions--Perspectives from the Bench and Mental Health; PTSD and Risk Assessments for Juvenile Court Evaluations; and The Need for Trauma-Informed Screening and Assessment in Juvenile Justice Settings--Strengths and Limitations of Commonly Used Instruments. Access is similarly provided to these publications: Assessing Exposure to Psychological Trauma and Posttraumatic Stress in the Juvenile Justice Population Fact Sheet; Testifying in Court about Trauma: How to Prepare and The Court Hearing; Think Trauma Training Course; Trauma among Girls in the Juvenile Justice System; Trauma-Focused Interventions for Youth in the Juvenile Justice System; Trauma Histories Among Justice-Involved Youth: Findings From the National Child Traumatic Stress Network; Victimization and Juvenile Offending; Trauma in the Lives of Gang-Involved Youth: Tips for Volunteers and Community Organizations; and Your Child and Gangs: What You Need to Know about Trauma - Tips for Parents.

Resource for Mental Health Cover

This document describes eleven screening tools designed to provide information about trauma in children and adolescents. The descriptions review their intended purposes, administration formats, administration requirements, age ranges, samples on which they have been validated, and available evidence of their psychometric reliability and validity (p. 1).

"Trauma is a widespread, harmful and costly public health problem. It occurs as a result of violence, abuse, neglect, loss, disaster, war and other emotionally harmful experiences. Trauma has no boundaries with regard to age, gender, socioeconomic status, race, ethnicity, geography or sexual orientation. It is an almost universal experience of people with mental and substance use disorders … The purpose of this paper is to develop a working concept of trauma and a trauma-informed approach and to develop a shared understanding of these concepts that would be acceptable and appropriate across an array of service systems and stakeholder groups. SAMHSA puts forth a framework for the behavioral health specialty sectors, that can be adapted to other sectors such as child welfare, education, criminal and juvenile justice, primary health care, the military and other settings that have the potential to ease or exacerbate an individual’s capacity to cope with traumatic experiences … The desired goal is to build a framework that helps systems “talk” to each other, to understand better the connections between trauma and behavioral health issues, and to guide systems to become trauma-informed" (p. 2-3). Sections of this publication include: introduction; purpose and approach—developing a framework for trauma and a trauma-informed approach; background—trauma—where we are and how we got here; SMAHSA's concept of trauma; SAMHSA's trauma-informed approach—key assumptions and principles; guidance for implementing a trauma-informed approach; next steps—trauma in the context of community; and conclusion.

SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach Cover

Seeking Safety is a therapeutic program for women suffering from trauma, substance abuse, and/or posttraumatic stress disorder (PTSD). This website provides abundant information regarding this program and trauma-informed treatment. Points of entry are: the book “Seeking Safety; outcome results from evaluations of Seeking Safety; a wide range of articles regarding the Seeking Safety model (description and implementation) and empirical studies about it, PTSD and addiction, cognitive-behavioral and other therapies, therapists and therapy, and other related articles; training; frequently asked questions (FAQ); assessment; online forum for questions, ideas, and comments on the use of Seeking Safety; and contact information.

Seeking Safety: A Model for Trauma and/or Substance Abuse Cover

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