Day one of National Safeguarding Adults Week – Adverse Childhood Experiences

Welcome to day one of National Safeguarding Adults Week – the aim of which is to create a time where we can all focus on safeguarding adults – so we can be better, together.

Today we are be focusing on raising awareness of Adverse Childhood Experiences (ACEs)

Help us to raise awareness of this key issue facing adults at risk by:

• learning about the issue from our resources and information
• sharing these resources within your organisation and with the people you meet
• using the #SafeguardingAdultsWeek hashtag on social media to share our resources and let us know what you’re doing
• holding safeguarding events and training
• Share our MSP NSW briefing DAY 1 ACE and ACE seven minute briefings

Adverse Childhood Experiences (ACEs) describe a wide range of stressful or traumatic experiences that may occur up to the age of 18.

The original ACEs study in the late 1990’s referred to ten specific categories of exposure:

• Abuse – emotional/physical/sexual
• Neglect – emotional/physical
• Household Dysfunction – domestic abuse; substance and alcohol misuse; someone with mental illness; parental loss (separation/divorce/bereavement); someone in jail.

Other types of adversity exists such as poverty, homelessness, bullying (including cyber-bullying), discrimination, and separation from a caregiver to foster care or migration.

Why Do They Matter?
ACEs are incredibly common – in the UK nearly 50% of people have experienced at least one ACE, with 9%-12% experiencing 4 or more ACEs.

There is a dose response relationship between ACEs and the development of poor physical, mental and behavioural health.

Experiencing 4 or more ACEs is associated with significantly increased risk for 7 out of 10 leading adult causes of death, including heart disease, stroke, cancer, COPD, diabetes, Alzheimer’s and suicide.

What Do We Know?
Exposure to intense, frequent, or sustained stress without the buffering care of a supportive adult can lead to long-term changes in our brains and bodies.

There is an increased risk of:

• developing high blood pressure and elevated levels of inflammation
• infection and autoimmune disease
• changes to the endocrine system leading to impacted growth and development
• disruption to the developing brain leading to an increase in risk of cognitive impairment, attention deficits, learning disabilities, hyperactivity, self-regulation, memory and attention, and anxiety.

In the face of interpersonal trauma, all the systems of the social brain become shaped for offensive and defensive purposes.

Why Is This Important To Manchester?
Manchester residents have poorer health outcomes and a lower life expectancy than people living in other areas of the country. We have one of the highest rates of premature deaths in the country and high infant mortality rates.

Health services alone cannot improve people’s health and reduce health inequality. We owe
it to our residents to change the way we work and do something differently to improve their health and reduce inequality across all age groups.

What Can We Do?
Look ‘behind the behaviours’ and consider what the root cause of the presenting behaviour may be.

Use protective factors to build resilience e.g. secure attachment, opportunities for positive activities and supportive networks.

Adopt a trauma-informed approach with a focus on ‘what happened to you?’ instead of ‘what’s wrong with you?’

Consider how to apply the core principles of trauma-informed practice:
Safety – Choice – Collaboration – Empowerment – Trust.

What Are We Doing?
Following a successful pilot project in Harpurhey we are rolling out ACE awareness training and developing trauma informed approaches across Manchester. We have a strategy that outlines our plans – this can be found in our  adverse childhood experiences resource.

Our ambition is to work towards Manchester becoming a trauma informed city by 2025. A city where we can break the generational cycle by preventing ACEs in our young people and strengthen resilience in individuals, families and communities leading to better life outcomes.

Further Information
If you want to get involved in this movement please contact:

• Gareth Nixon, Project Manager at gareth.nixon@manchester.gov.uk
• Daniel Unsworth, Senior Researcher at daniel.unsworth@manchester.gov.uk