England & Wales Education and children's services

Scotland’s ACE Journey: The Road to Resilience

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LGiU Scotland’s Isla Whateley looks at Adverse Childhood Experiences (ACEs), and what Scotland is doing to become more ACE-aware.

In August, I was lucky enough to attend Health and Social Care Alliance (the ALLIANCE) Scotland’s screening of Resilience: The Biology of Stress and the Science of Hope, as part of the Declaration Festival of human rights. The film is a documentary that looks at the links between Adverse Childhood Experiences (ACEs) and poor health/disease in adulthood. The screening was followed by a panel discussion with panellists from the Scottish Youth Parliament (SYP), NHS Health Scotland, Together (Scottish Alliance for Children’s Rights), Parent Network Scotland, Rape Crisis Scotland and the ALLIANCE, with a particular focus on equalities and the human rights aspect of ACEs.

Research on adverse childhood experiences, or ACEs,  began in the 1990s, with the pivotal ACE Study being conducted in the mid-1990s in America. ACEs are categorised into three groups – abuse, neglect and family/household challenges. This includes emotional, physical and sexual abuse; emotional and physical neglect; and household violence, substance abuse, incarceration mental illness or parental separation. The first study proved that people with a higher incidence of ACEs suffered many more health issues in adulthood, leading to early death. ACEs are normally assessed out of 10, and people work out their ‘ACEs score’. If your score is 3 or higher, this means it has significant effects on your adult health.

The film outlines the history of the work done on ACEs as well as some harrowing statistics. Those with a higher number of ACEs are more likely to have substance abuse issues, use prescription drugs, are 2 to 5 times more likely to attempt suicide, have trouble conceiving and much more. It is clearly a huge public health issue that needs to be tackled – so what is being done?

In the US, many ACE experts focus on building resilience through an intergenerational approach. The film focuses on the school curriculum called Miss Kendra’s list – a way of letting children know their rights and what they can do if they feel their rights are being violated. In the film, the children write to Miss Kendra anonymously about their worries and they all get personalised replies. In places where the curriculum has been in place for a couple of years, teachers see a notable difference in children’s wellbeing and confidence as they grow older from being trauma-informed.

There were a huge amount of interesting things discussed by the panel. Issues included the role of parents, the importance of the UN Convention of the Rights of the Child (UNCRC), sexual violence, integrative care, the role of education, structural health inequalities, poverty and the importance of communities. It was great to be a part of the event and hear all the ideas people had and what various organisations were doing to become more ACE-aware.

Scotland is currently trying to become a more ACE-aware nation – with conferences, programmes and discussions happening all over the country. This is something that could change the way we all think about public health and practice healthcare, with a proven scientific basis. It is important that this momentum builds and that national government, local authorities, health boards and all community planning partners across Scotland begin to implement ACE-aware policies and factor it into their work.