Symptoms and functional impairment, such as maladaptive coping strategies, decreased performance in school or work, and relationship dysfunction, are often more severe when individuals experience cumulative adversity and poly-victimization. Trauma amplifies health disparities, taxing already scarce or strained individual, social, and community resources.

Some adults who have experienced adversity when they were children have a more challenging time providing a safe and nurturing environment for themselves and their children. Furthermore, parents with a history of ACEs can increase the risk that their children may also experience adverse childhood events.

Individuals with experiences of trauma or prolonged adversity interact with multiple service sectors, not just mental and behavioral health.  Studies of individuals within the juvenile and criminal justice systems reveal high rates of mental health and substance use disorders, as well as significant personal histories of trauma. Similarly, children and families within the child welfare system face high rates of trauma and associated behavioral health issues. Young people often carry these traumatic experiences into school systems, which can hinder their academic success. Many patients in primary care also have considerable trauma histories that affect their overall health and responsiveness to health interventions. Additionally, given the prevalence of ACEs, agencies are likely to hire employees with ACEs at all levels of the organization.

Healthcare professionals and others who work directly with families play a crucial role in mitigating and preventing ACEs. Clinical interventions typically focus on treating trauma and fostering safe, stable, and nurturing relationships (SSNRs). However, many trauma survivors report that these interventions alone are not enough. Enhancing agency conditions by promoting psychological safety – through the climate and conditions in which services are provided across systems – can be transformational to individuals, families, employees, and the broader community.

ACEs also impact the workplace. Employees often bring personal challenges to work that can affect their behavior and performance. These challenges may include stress resulting from trauma, abuse, or other destabilizing events. Workplaces can exacerbate this stress through dysfunctional cultures, inadequate safety measures, or poor management.  Toxic stress and trauma can lead to increased absenteeism, decreased productivity, and safety concerns, particularly in human services, where compassion fatigue is prevalent. Adopting a trauma-informed approach can help prevent burnout and create an environment where employees feel heard, valued, and supported.