3 days ago
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ACCORDING TO Professor Wendel Abel, professor of mental-health policy in the Department of Community Health and Psychiatry in the Faculty of Medical Sciences and consultant psychiatrist at the University Hospital of the West Indies, Mona, trauma creates negative mental, behavioural, and physical outcomes during childhood and across the life cycle into adulthood.
Childhood trauma has become a major public-health problem, and to break this vicious cycle of harm, we need to use a comprehensivechi public-health approach using multipronged interventions.
“In general, public-health interventions target communities and populations and are multilevel in their scope. In Jamaica, public-health efforts are focused primarily on injury, chronic diseases, and, recently, specific behavioural-health issues such as alcohol and substance abuse, suicide, and violence,” Professor Abel said.
“A public-health approach to the widespread problem of childhood trauma does not exist in Jamaica. There is an urgency for us to address the pervasive childhood trauma in a more comprehensive manner in Jamaica,” he added.
PUBLIC EDUCATION AND AWARENESS
Public-health interventions utilise strategies such as public education and awareness, prevention, early intervention strategies and treatment. The levels of intervention include those that are child and family-based and community and society-based.
An understanding of the stages in a child’s development at which we can act, he said, has allowed practitioners to better target these interventions. This approach is critical to enabling us to prevent trauma and promote healing and recovery from childhood adversity.
“An evolving body of research identifies many interventions to address childhood trauma, and these range from those that can prevent or reduce childhood trauma to those that respond to trauma when it occurs and those designed to enhance coping,” Professor Abel said.
Interventions, he said, may be directed at all levels across the socioecological spectrum: the child, family, community, and the wider societal level.
CRITICAL PERIODS
In the development of interventions targeting childhood adversity, three critical periods or windows of vulnerability and intervention have been identified. The first window is the first thousand days, a period from conception to the end of age two.
This is a period of rapid brain growth when the child is extremely sensitive to stressors. The second occurs at about nine to 14 years of age. This period corresponds with early adolescence, which is critical to the development of children. The third window occurs between 18 and 21 years, which marks the transition to adulthood.
This is the period when young people are making that transition from adolescence to becoming young adults. These periods provide opportunities for action.
“Prevention efforts are the most cost-effective measures for tackling any public-health problem. We, therefore, as a society, need to focus on prevention as it costs less to fix things before they occur,” Professor Abel said.
There is an urgent need, he said, for more community-based programmes targeting youth, especially youth from high-risk families and communities. These programmes should be geared at enhancing resilience and promoting the acquisition of life skills and social skills.
“As the often repeated saying goes, ‘It takes a village to raise a child’”. This highlights the fact that when families and communities provide safe, stable relationships and environments, children have more positive experiences, encounter less trauma, and they thrive,” Professor Abel said.
Given the high level of crime and violence in Jamaica, continued efforts, he said, are needed to reduce community violence and the exposure of children to crime and violence. Community-awareness campaigns involving mass media and social media and building community networks to provide support and advocacy (for example, faith based, service clubs, NGOs) are strategies that can be introduced.
“An evolving body of research has shown that programmes with multiple components are more effective. Many programmes have been supported in Jamaica to address parenting practices, decrease violence, and many of the adverse childhood experiences and related risk factors,” Professor Abel said.
PROPERLY EVALUATED
“Unfortunately, however, despite the millions of dollars spent, many of these programmes have not been properly evaluated to establish what works and what does not work. There are, however, some programmes that have provided evidence of their effectiveness,” he added.
The GraceKennedy Foundation was established in 1982 to celebrate the company’s 60th anniversary. Its aim is to be a world-class corporate foundation driven by its mission to support its parent company, GraceKennedy, as a corporate citizen, by creating environmentally sustainable programmes, promoting healthy lifestyles, and increasing access to education.
Since 1989, the GraceKennedy Foundation has used its lecture series to engage the Jamaican public, both locally and in the diaspora, to promote discussion and debate on relevant topics affecting the Jamaican society.
Several of the lectures have become important sources for reference in their fields. A number have been assigned as texts at both The University of the West Indies and the University of Technology. Two titles have been in constant demand by schools and the general public and have had to be reprinted. These are Elsa Leo-Rhynie’s The Jamaican Family: Continuity and Change and Don Robotham’s Vision and Volunteerism.
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