Chief Executive SallyAnn Kelly suggests in this blog that by broadening our understanding of the work around Adverse Childhood Experiences and the root causes of adversity, Scotland could lift more children out of poverty.
I recently participated in a panel discussion that followed a screening of Resilience: The Biology of Stress and the Science of Hope, hosted by the Health and Social Care Alliance at the Scottish Storytelling Centre in Edinburgh. The screening was part of the Declaration Festival 2019, a unique partnership between the Mental Health Foundation, the Health and Social Care Alliance Scotland (the ALLIANCE), NHS Health Scotland and the Centre for Health Policy at the University of Strathclyde. The festival aims to explore the First Minister’s vow to ‘do even more, even better on incorporating human rights in Scotland’, and is part of an on-going commitment to the right to health and social care in Scotland.
The film highlights the development of research by the scientific and medical communities since the 1990s of the impact of adverse childhood experiences (ACEs) on long term physical and mental health. The ACEs discussion, some argue, provides the basis for a new understanding of the problems facing society as a result of the impact of ACEs and childhood trauma, and how to best treat families dealing with toxic stress. The film’s key message is that with this information and new understanding of childhood adversity, we can act quickly to develop policy to mitigate the effects of a public health crisis.
It was the fourth time I had seen this film. It is a fascinating film to watch. I always ask people to remain curious throughout about the implications of what the ACEs research means and what it can be used to inform. It seems to me that there are some questions we need to think about in terms of the application of what the film and the research tells us. It does present us with a clear message that, as a society and a country, we need to realise change to prevent adverse childhood experiences, and I agree wholeheartedly with that. However, in relation to the ACEs discussion that has been going on in Scotland in recent years, I am of the view that we have framed the story too narrowly, and there is a pressing need for us to come together to broaden the narrative and ensure that we understand and address all adversity – not just those highlighted in the ACEs research.
The ACEs approach also focuses only on adversities children experience in families. There is an absence of acknowledging the impact of social determinants of childhood adversity and adult health, such as poverty and inequality. I am curious about how the ACEs stories have been accepted by policy makers, in a way that poverty stories have struggled to get attention and action. This is something I was able to discuss at another event I spoke at recently, which was the launch of ‘Protecting Children – A Social Model’ by Brid Featherstone et al. The authors present some compelling questions for us about how best we support children and families and what changes are required in order to improve the opportunities for all of our children.
Unsurprisingly poverty, discrimination and disadvantage played a very big part in the discussion – as did the need for us to return to an approach across our public services that is based not only on building authentic supportive relationships within and across organisations, but, more importantly, alongside the people we seek to support. Key questions were asked about the role of the state in creating social harm by pursuing policies and approaches that damage individuals and the communities in which they live, whilst simultaneously blaming those same people and those same communities for not being able to ‘fix’ themselves. This is an approach which persists in many western democratic societies. Even though we know that in countries where there are good relationships within society, a high level of engagement, the value of human beings is not linked to wealth generation or income, and human relationships and human rights are valued – we find quality of life is high and levels of adversity are lower. We need to look at what this means for us and the individual and societal changes we need to make if we are truly to be able to make Scotland ‘the best place in the World to grow up’.
We also need to remain curious about the whole of the ‘so what’ and the ‘how’ in all of this. So what will it take to create that fairer and more equal Scotland we seek to build?
It is as bad in Scotland
The report on poverty in the UK by Dr Philip Alston, the UN Special Rapporteur on Extreme Poverty and Human Rights, will be published this week and it is a report that should make all of us listen better and act more decisively. We should not be seduced into the ‘it’s not as bad in Scotland as it is in England’ narrative, because that will ring hollow for the 240,000 children and their families living in poverty in Scotland right now. As a first, but decisive step following publication we need to use the levers that we have at our disposal, before it’s too late, to make a lasting difference to each and every one of those children and do what we can to protect them from further adversity, missed opportunities and, in many cases, trauma. We need the Scottish Government to agree to increase their commitment to address poverty now. We know that the biggest single thing that we can do to prevent poverty associated toxic stress and consequential adversity is to lift families out of poverty. We know that putting money in the pockets of parents can help them to live a life where they are able to support themselves and their children to flourish.
We also know that this needs to be supported by a state which wholly respects human rights, is compassionate and which understands and responds to adversity and trauma. We have made some great progress in law and policy in Scotland and the recent announcement by the First Minister on full incorporation of the United Nations Convention on the Rights of the Child should provide a solid building block toward fair and equitable realisation of Children’s Rights and allow us to address the implementation deficit that we currently experience in relation to existing law and policy in Scotland.
Please, let’s help Scotland’s children flourish!
SallyAnn Kelly, Chief Executive, Aberlour.