In Jul 2017 Te Pou o te Whakaaro Nui (Te Pou) and Werry Workforce Whāraurau, supported by NGO Pathways, sponsored two New Zealand screenings of the important documentary Resilience – the biology of stress and the science of hope. They did this in conjunction with Janet Peters, a consultant, writer and registered psychologist. Screenings were held in Auckland (13 July) and Wellington (19 July). 
 
Resilience is based on findings from the extensive Adverse Childhood Experiences study (ACEs), a research project by American health organisation Kaiser Permanente and the Centres for Disease Control and Prevention. In a nutshell, trauma experienced in childhood can have significantly negative impacts on mental and physical health outcomes later in life.
 
A major premise in Resilience is that what’s predictable is preventable, so the documentary chronicles the rise of a movement in the US that includes physicians, educators, teachers, social workers and communities who are daring to talk about the effects of divorce, abuse and neglect. They are using cutting edge science to help the next generation break the cycles of adversity, disease – “and the dark legacy of a childhood no child would choose”.
 
When these people and communities began implementing “trauma-informed” policies and practices they saw drastic reductions in rates of everything from dropping out of high school to teen pregnancy, youth suicide and domestic violence. 
 
Werry Workforce Whāraurau and Te Pou have been doing a lot of work around developing knowledge of trauma-informed care within the mental health workforce, and this was the main reason for sponsoring the screenings. However, both organisations also see it as vitally important to raise awareness, wherever children and families are involved, about the science behind what contributes to adverse childhood experiences. This would include the addiction, physical health, mental health, public health, primary care, education and justice sectors, the Police and Ministries such as Social Development and Oranga Tamariki. 
 
It also has implications for large areas of New Zealand research such as Growing Up in New Zealand and the Dunedin study which found that people who become users of health services, criminal justice and social welfare can often be identified by the age of three.
 
The aim of the work in the US has been three-fold:
1. Prevent the long-term effects of ‘toxic stress’ in childhood by raising national awareness among those who have the power to make a difference – all agencies and including the general public.
2. Have agencies screen children as soon as possible for adverse childhood experiences.
3. Show leadership in developing the best ways to heal children who have experienced or are experiencing stressful lives.
 
New Zealand is still in its infancy when it comes to having policies and approaches that link adverse childhood experiences and mental health, addiction and physical health problems – let alone in terms of prevention, screening or healing – but there are signs of promise.
 
The launch of Oranga Tamariki in April 2017 is a positive step and the Ministry of Social Development is looking at advancing trauma-informed practice across New Zealand – initially for social workers. However, Te Pou and Werry Workforce Whāraurau believe the ideas inherent in Resilience tie in with Ministry of Health’s Rising to the Challenge mental health and addiction plan. A life course, preventative approach to the planning and delivery of contemporary mental health and addiction services is needed.

 

The New Zealand screenings

The screening at the University of Auckland on 13 July was attended by around 200 people. MC’d by Jo van Leeuwen from Te Pou, speakers included Children’s Commissioner Judge Andrew Becroft, psychologist Janet Peters and Dr Sarah Berry and Alex Woodley of the Growing up in New Zealand study.
 
The screening at Victoria University of Wellington on 19 July was attended by around 160 people and had Andrea Bates of Wellbeing Wellington as its MC. Speakers included Children’s Commissioner Judge Andrew Becroft, psychologist Janet Peters and Dr Nikki Turner.
 
Andrea Bates said that, while trauma-informed care is not a new concept for those working in mental health, there needs to be a real push to move from embracing a series of principles towards actually putting the message of the documentary into play. 
 
“That’s what’s really important about this documentary,” she said.
 
“It’s talking about how we do that, and the conclusion I draw from the film is that it reveals just how much work we have yet to do.”

Children’s Commissioner Judge Andrew Becroft started by talking about some young people he had encountered during his previous role as a youth court judge, especially in terms of addressing trauma. He spoke of backgrounds of chronic domestic violence, substance abuse and young people whose adverse childhood experience scores would be sky-high. Those who had victimised and abused others had almost always been victimised and abused themselves as children.

“So what is it that balances out those adverse childhood experiences and the trauma that has gone on? One of those things is resilience. Trauma is in the past, but resilience is something we can do something about. That’s why I’m so intrigued to see this documentary tonight,” he said.

“The starting point is being really child-centred, taking children’s voices seriously, hearing what they say and factoring them into our decision-making. Children have wisdom that means they add value to any of our policy-making, but most of our communication with them is superficial.”

He said a child’s life is like a chair with four legs. They need strength in four areas: home/family; school; friends; and community. 

“And they need a sense of values linking these. Every child needs to see a values system and our work is about strengthening these four areas. This is how we will build resilience in kids.”

Janet Peters spoke of her own adverse childhood experiences and shared her personal story in the hope that it would add another layer to what could be learned from the screening.

Her much loved parents experienced mental health issues and couldn’t cope looking after the children. She developed anxiety in childhood and felt a lack of connection as well as stigma and discrimination from her community. She was using drugs and alcohol heavily by her teens and engaging in a number of risky behaviours.

It wasn’t until she was 25 that she began turning things around, attending university and starting a new life that, she says, is still very much a work in progress at 62.

She says listening to Dr Nadine Burke (featured in the documentary) back in 2014 was a total lightbulb moment for her and she encouraged the audience to listen to Dr Burke’s Ted Talk, How childhood trauma affects health across a lifetime

“We’ve got to do so much better for children. So I believe the impact of understanding adverse childhood experiences needs to happen across government in New Zealand, not just in health,” Janet said.

“Tonight I hope we start a national conversation or social movement. The documentary is very powerful and it’s neat that some New Zealand agencies are now picking up on its messages.”

General practitioner and health spokesperson for the Child Poverty Action Group Dr Nikki Turner also spoke about how we could bring the concepts of the documentary to life here in New Zealand. 

She gave examples from her own practice of people who had adverse childhood experiences and said the stories behind the children coming back to be seen over and over are saddening.

“In the end we can put up the graphs and the data, but it’s the stories that move our hearts and help us recognise the harm these adverse childhood events do.”

She said that from recognition we get the knowledge we need to take forward with our colleagues.

“The next thing we really need, and that we lack as a society, is empathy. One of the people in the documentary said, ‘We are captivated by the self-made person concept and individual fault’ they hit the nail on the head – the sense that it’s the person’s fault, or their mother’s fault, that it’s not our fault as a society.”

And, lastly, she said we need to be angry. 

“We know these statistics. The ACE data is not new and we are not doing enough as a country about how many children live in poverty. This is where our anger should come from.”

She closed by noting a comment from the documentary that ‘if you can get this into the hands of the general population, they will invent some very wise solutions’. 

“We have solutions, ideas and plans, we just need resources and support for them,” she said.

Screenings and finding out more

Resilience is usually very popular with most screenings, including those in Auckland and Wellington (and overseas), being sold out weeks in advance. It is not available online so anyone wanting to see the documentary is encouraged to make the most of any opportunity they come across to see it.

It is possible for community groups to arrange screenings of their own. Find out more.

More about the ACE study

The Adverse Childhood Experiences Study (ACEs) is a research project by American health maintenance organisation Kaiser Permanente and the Centers for Disease Control and Prevention. Participants were recruited to the study between 1995 and 1997 and have been followed up in terms of health outcomes over their lifetimes. 

It reveals how toxic stress, caused by abuse and neglect during childhood, can trigger hormones that wreak havoc on the brains and bodies of children, putting them at a greater risk for disease, homelessness, prison time, and early death. It’s something that affects people in all segments of society.

The ACE study dared to ask questions such as: Were you sexually abused as a child? Did you have a parent who was an alcoholic? The answers produced a public health revelation. For the first time, the loss of a parent through death, divorce or incarceration and other traumatic childhood experiences, such as living with an alcoholic parent or being sexually abused, were conclusively linked to both physical and mental health problems later in life. 

A person’s ‘ACE score’ is a tally of the different types of abuse, neglect, and other hallmarks of a traumatic childhood that apply to them. The higher your score, the higher your risk for later health problems such as early onset heart disease, diabetes, addiction and depression. 

About the documentary makers

Resilience is directed by experienced documentary maker James Redford, who is also co-founder and chair of The Redford Center, a film production non-profit that translates complex environmental challenges into human stories that inspire.

Resilience was also produced by James in collaboration with Karen Pritzker. The two first worked together on The Big Picture: Rethinking Dyslexia, a film that gave hope to millions of families around the world. Their next film, Paper Tigers, was about the hidden menace of adverse childhood experiences. Resilience is designed to be a companion piece to this work.

Janet Peters contacted Jamie through an IIMHL contact in the US.  He was willing to meet with her and representatives of Te Pou, Werry Workforce and Pathways in Auckland in February 2017. 

James says the science of toxic stress and the major findings that came out of the ACE study should be common knowledge public health information, and that is a major objective this documentary sets out to achieve.

“Who knew that if your parents got a divorce when you were growing up, you have a significantly higher risk of heart disease? Or that if your mother had a drinking problem, your own risk for depression in adulthood is much higher?” he says.

“We started making Resilience to make this science digestible and relevant to everyone, and to showcase some of the brave and creative individuals who are putting that science into action.”

 

  Te Pou kaumatua Tepene Karaka (who opened the evening)  with Judge Andrew Becroft (centre) and Janet Peters

 

 

 

 

 

 

 

  Andrea Bates

 

 

 

 

 

 

 

  Children’s Commissioner Judge Andrew Becroft

 

 

 

 

 

 

 

  Janet Peters

 

 

 

 

 

 

 

  Dr Nikki Turner