By Natalie Ramm
The views expressed in this post are those of the author, and do not necessarily reflect the opinions of the Journal, the William H. Bowen School of Law, or UA Little Rock.
Childhood adversity, otherwise known in the research as adverse childhood experiences (ACEs), can cause developmental delays, behavioral problems, and poor health outcomes. Childhood adversity is all around us. In fact, 56% of children in Arkansas have experienced at least one ACE. And as many as one in seven children in the state have experienced three or more.
ACEs are divided into three broad categories: abuse, neglect, and household dysfunction. Abuse includes physical, emotional, and sexual abuse. Neglect includes both emotional and physical neglect. Household dysfunction includes having someone in the home with mental illness, witnessing violence in the home, having a parent or caregiver abuse alcohol or drugs, having a family member or caregiver who is incarcerated, and divorce. People from all walks of life experience ACEs, but children in poverty may experience ACEs at a higher rate.
Furthermore, people who have experienced trauma as children are more likely to come into contact with law enforcement and the criminal justice system, perhaps because they are more likely to suffer from addiction and carry out interpersonal violence.
Communities all over the country are wrestling with how to address ACEs. The research has shown that an approach including both (1) direct services for children and families who are currently suffering and (2) community education on prevention are the most effective. Lawyers have a critical role to play in both direct services and community education.
The largest role lawyers and legal services organizations can play in the battle against ACEs is to provide direct services that are trauma-sensitive; for example, defending criminal defendants, settling family disputes, obtaining guardianships, or advocating for tenants in unhealthy living situations. Because trauma takes a way a person’s sense of safety and control, trauma-sensitive practice involves sharing power and allowing clients as must control as possible to show that you respect them (Dr. Edge, presentation at ACEs Summit, Sep. 25, 2018).
Legal services and medical institutions have created Medical-Legal Partnerships (MLPs) all over the country, and the main goal of MLPs is to address social determinants of health. Social determinants of health include many of the same things that affect ACEs like poverty, homelessness, and hunger. MLPs are likely already serving people who have experienced childhood adversity. They can make organizational changes to improve direct services for people who have experienced trauma, such as training staff in trauma-sensitivity, ensuring that its staff is diverse, and even building trauma-sensitivity into individual employee performance reports (Dr. Edge, presentation at ACEs Summit, Sep. 25, 2018).
One could provide direct services forever and never solve the root cause of those problems. That is why many programs directed at alleviating ACEs include community education and involvement. The most obvious educators include medical doctors and psychologists, who are well versed in the science behind ACEs and ways to prevent them. In a comprehensive community education plan, however, lawyers could have a role in educating the community on things like conflict resolution, what legal rights people have in certain situations like being pulled over or being a tenant, what government benefits they have access to, and how to report instances of abuse or neglect.
In addition to solving legal issues and helping with community education, lawyers could help address ACEs in other ways. As Amy Johnson from the Arkansas Access to Justice Commission said at the recent ACEs summit in Little Rock, the legal system itself can re-traumatize those who have experienced ACEs. Lawyers are in a position to not only navigate that system for clients but also to advocate for changes to the system that could benefit individuals and the community as a whole. Finally, implementing trauma-informed training in law schools nationwide, could help young attorneys use trauma-sensitive practices when they are working directly with clients.