The Art and Science of Trauma - ‘Associate of Directors of Public Health put their cards on the ‘able’

Today was a good day as the Assistant Directors of Public Health (ADPH) published a position statement on 30th October 2023 entitled ‘What we say about….Childhood Adversity’ and I was particularly pleased to read the statement: Trauma informed approaches should be adopted in all services.

Long awaited from my perspective…..

I worked in NHS Public Health and following the Health and Social Care Act (2012) transferred to Local Authority Public Health. In my roles, I was passionate about addressing health inequalities and saw the work of Vincent J. Felitti, MD, FACP, and Robert F. Anda, MD, MS, et al, ‘Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults (1998) as areal game changer. The study became known as the Adverse Childhood Experiences (ACE) Study, and in 2016 began to take on momentum and trauma informed approaches and practice was on the horizon.

It was exciting times as further studies in the Scotland and Wales produced very similar findings, and I led the debate with my colleagues in an East Midlands Public Health development event. There is a need for a national Trauma Training programme to be developed in England, we can learn from the practices in Wales and Scotland, and from the work of Dr Jack Shonkoff, who advocates for increasing the capacity of adults to improve the outcomes for children, and future generations.

I was in a fortunate position that I had a supportive DPH and was able to commission resilience building programmes in schools and a system-wide approach training staff in health and social care and protection services in trauma informed approaches.

Then Covid19 hit and hit those with health inequalities hardest; it was time to do more, and I joined KCA to be able to be able to do that.

Key messages from the report are;

• The physical, emotional, and mental wellbeing of babies, children and young people are significantly shaped by the social determinants of health in which they are born, live and grow.

• A child can be vulnerable to the impact of action or inaction by other people and their physical and social environment, including poverty, social inequalities, and structural racism.

• A whole system approach is needed to address the determinants of child health, with strong national policies and joint working between the NHS, housing, education, social services, and youth justice sectors. Health visiting and midwifery services, as the universal early years support services, are uniquely placed to facilitate early access to services according to families’ needs.

• A shift towards prevention and early intervention is needed to support babies, children, and young people to lead healthy and fulfilling lives and prevent ill-health in later life.

Trauma informed approaches should be adopted in all services as it recognises that service users may have experienced trauma that services do not routinely consider. A lack of awareness can lead to social exclusion, a lack of support or onward referral, possibly resulting in re-traumatisation.

KCA endorses this approach and advocates for all services to be trauma informed across the life course, because neuroplasticity means that our brains continue to develop and change in response to our internal and external environments.

Read more, see the full reports here:

What we say about… Childhood adversity | ADPH

Formatted-FINAL-Childhood-Adversity-Policy-Position-Statement.pdf (

If you want to talk more about the role Public Health has in promoting trauma informed approaches then contact Ann Berry at