Crystal Brandow: Hi everyone. Thank you for joining us today for our webinar,
Fostering Community Wellness: Addressing Toxic Stress and Adverse Community Events. My name is Crystal Brandow, and I am the Assistant
Director of SAMHSA’s Program to Achieve Wellness, and we’re very delighted to have an excellent
panel of speakers here with us today. They’ll get a thorough introduction shortly,
but we have Jasmin Brandow of Humankind Workshop, Reuben Cantu of The Prevention Institute,
and Richard Smith of Healing Works by Common Justice. So, again, we’ll give these speakers a thorough
introduction, but before we get started, we just need to go over some housekeeping items. And that is this disclaimer here that the
view expressed in this training do no necessarily represent the views, policies, and positions
of the Center for Mental Health Services, the Substance Abuse and Mental Health Services
Administration, or the U.S. Department of Health and Human Services. So, again briefly before I hand it over to
Jasmin Brandow who’s our moderator, the topic today is Addressing Toxic Stress and Adverse
Community Events. So, what you’ll see on your screen right now
is a file share box where you can download a fact sheet on this topic. So, we hope that in today’s discussion, you’ll
get an abundance of information that’s helpful for you and your communities, and the fact
sheet that’s available on your screen now that you can download, further detail some
of these topics, and have some additional resources that you can go to. So, this fact sheet is on the screen. It’ll disappear momentarily, but we will have
it back up for you by the end of the webinar. So, I will go ahead and introduce our moderator
for today. Next slide please. Thank you. So, moderating this discussion, again, is
Jasmin Brandow. She is the co-founder of Humankind Workshop
and a consultant with SAMHSA’s program to achieve wellness. Jasmin is a facilitator and trainer committed
to empowering people through intentional conversations about identity, awareness and impact. She has a B.A. in Sociology from the University
of Albany and a M.A. in Political Science from the Nelson A. Rockefeller College of
Public Affairs. Jasmin’s work has focused on policy in projects
related to preventing workplace violence, increasing access to justice, and addressing
disparities in the Child Welfare and Juvenile Justice System. In 2015 Jasmin co-founded Humankind Workshop
to develop and share learning experiences that bring people together around topics like,
culture, trauma, bias and humility, all of which are essential to what we’re talking
about today. So, with that I am going to hand it over to
Jasmin for a thorough introduction to today’s topic. Jasmin Brandow: Thank you so much, Crystal,
and welcome everyone. We want to thank you for choosing to be with
us on today’s webinar. As part of our panel, we will be hearing from
Crystal again in a little bit, and we’ll also be talking with Ruben Cantu, Program Manager
with Prevention Institute and Richard Smith, the Healing Works National Director at Common
Justice. Before that, let’s talk a little bit about
today’s objectives. By participating in today’s webinar, we hope
that you’ll be able to define toxic stress and community trauma, recognize the connection
between social determinants, toxic stress, community trauma, and mental health, understand
the impact of various events on individuals with serious mental illness, and of course
identify strategies for mitigating the effects of toxic stress and community trauma. A little bit more about Ruben Cantu and Richard
Smith. Ruben manages programs in addressing community
trauma, mental health, and violence prevention at Prevention Institute. He has more than 20 years of nonprofit experience
in public health, equity, program, and organizational management, and technical assistance in capacity
building. Ruben has worked extensively with organizations
and community members fighting to advance health equity for the under-served. Richard Smith has nearly two decades of experience
developing and implementing community based programs for disadvantaged populations. Richard has guest lectured at numerous colleges
and universities on issues such as racism, mass incarceration, and trauma and healing. Richard is currently the National Director
of Healing Works, a national learning collaborative for people working with young men of color
who have been harmed by violence and their communities. So, we want to thank all of our panelists
for joining us today. First, we’ll start by reviewing a few definitions. These definitions are available on the fact
sheet for download in the popup window of your screen. Trauma is a common experience for adults and
children in American communities. And it is especially common in the lives of
people with mental health and substance use disorders. SAMHSA defines trauma as an event, series
of events, or set of circumstances that is experienced by an individual as physically
or emotionally harmful or life threatening, and that has lasting adverse effects on the
individuals functioning and mental, physical, social, emotional, or spiritual wellbeing. Occasional stress is healthy and normal. However, chronic or severe stress can cause
significant problems with health and development. Stress that creates additional challenges
for a person’s functioning is known as toxic stress. And toxic stress can create potential challenges
over an entire lifespan. When toxic stress is the
result of an adverse community experience, such as a natural disaster or a mass shooting
incident, community member may be impacted in different ways and some will experience
trauma and its symptoms. Now, according to SAMHSA resilience refers
to the ability of an individual, family, or community to cope with adversity and trauma
and adapt to challenges or change. We just wanted to review these definitions
with you. Again, you can reference them in the fact
sheet, so we have some shared language and understanding for the conversation that’s
coming ahead. Now, before we begin talking with our panelists,
we want to first ask a question for all of our participants, and you can use your chat
box to share your responses. What are some sources of community trauma? Might be something that you heard, or something
that comes to mind, or something from your own experience. But just take a moment. We’ll pause and please use your chat box to
share. What are some sources of community trauma? Okay, great. We’ve got a few responses coming in. We’ll just wait another few seconds. … Okay. Examples including things like school shootings. Yes that’s an example. Got a few more. Great. And now we’re going to share some examples
with you as well. Because some of us are using the same language. So, some examples of community trauma or sources
of community trauma may include things like shooting incidents, natural disasters, community
violence, corporate irresponsibility, racism, sexism, homophobia and other kinds of -isms
that people have to survive structurally, poverty, discrimination, and lack of opportunity. Now, we’re going to get to speak with Crystal
Brandow again and she is going to be talking with us about social determinants as related
to adverse community experiences. Crystal Brandow Great, thank you so much for
that introduction Jasmin and I do want to point out that as you asked that poll question,
some answers went in chat and we also got quite a few answers in the Q&A box. So, I just want to thank the audience for
their participation. We have things in here, tornado, natural disasters,
mass shootings, neighborhood shootings, witnessing car accidents, so we had some responses that
came in. So, thank you all for engaging. That was our first kind of poll question that
we have here for you all. And we have a couple more throughout today’s
discussion to make sure that everyone is really practicing the information and has the space
to share their thoughts on what we’re talking about. So, again, thank you to Jasmin for that and
like Jasmin mentioned, I’m going to be talking a little bit about social determinants. Social determinants are connected with toxic
stress, community trauma, and mental health, all of which we’re talking about today. The Centers for Disease Control and Prevention
or, the CDC, notes that social determinants upheld are the circumstances in which people
are born, grow up, live, work, and age, and that these circumstances are shaped by a wider
set of forces like, economics, social policies, and politics. And we’re going to hear a little bit more
about that today when we talk with Ruben and Richard, who will share some information from
different programs that they worked on in different applications of this work in the
national space. But, to dive a little bit deeper into social
determinants, these are some examples of negative social determinants. So, they’re consider negative. They’re examples of structural violence, which
can inflict harm on communities. These include things like poverty, discrimination,
social exclusion, poor quality education, lack of access to quality healthcare, and
little or no access to quality foods. So, these are the circumstances in which people
may be living, working, being surrounded by, that can have negative impact on mental health,
overall wellbeing, and health status in general. On the other hand, these are some positive
social determinants: social support and inclusion, having nurturing families for children, good
health education, positive role models, opportunities for engagement in the community, and access
to healthy food. So, even just looking at this list as compared
to the negative social determinants list, you can see that these things may be much
more inclined to help build healthier communities, healthier residents in those communities,
and a community of inclusion and support. And so, we’re going to talk more about how
these social determinants play a role in toxic stress, community trauma, and adverse community
experiences, as well as the different protective factors that individuals in communities can
engage with to try to shift towards the more positive side of the social determinants in
this spectrum here. So, when thinking of social determinants,
the notes that there’s five key domains. So, there are many social determinants. I just named some examples of positive ones
and some examples of negative ones, and according to healthy people 2020, the five key determinants
are listed on the screen here. So, all the determinants can be broken down
into one of these five domains for the most part. And they are Economic Stability, which includes
poverty, employment, food insecurity, housing instability. Education, in a community how many individuals
have graduated from high school or are enrolled in higher education, language and literacy,
and childhood education are all part of this education domain. The Social and Community Context involves
social cohesion, civic participation, discrimination, and incarceration. Health and Healthcare are particularly important
when we’re talking about mental health. This includes access to care, physical healthcare,
mental healthcare, and health literacy. And finally, the Neighborhood and Built Environment
is the fifth domain, and this includes things like access to foods that can support healthy
eating, quality of housing and environmental conditions. So, when we think of environmental conditions,
this includes things like the quality of a sidewalk in a neighborhood. Is the neighborhood walkable? Does it seem safe? These are things that constitute the Neighborhood
and Built Environment. So, this is just a really quick overview of
social determinants and the five key domains. And like I said, our speakers today, Richard
and Ruben, are going to dive deeper into how these actually apply in the real world and
in real life settings. So, we’re going to pause quickly here and
just do another poll question. Keeping in mind what we just shared about
social determinants, please, we’d love if you’d use your chat box and let us know what
you think some of the social determinants are that can impact mental health and wellbeing. So, the positive determinants just shared,
the negative ones, as well as the five overarching domains, what do you think are those that
can impact mental health and wellbeing? So, please, use your chat box and share with
use your thoughts on this. And we’ll give everyone just a second to think
about that and start sharing their responses. Great. We have someone mention poor access to mental
health and other wellness services. Access to affordable transportation. Great … Alright. These are excellent recommendations, or excuse
me, responses here. Social economic status. Lack of professionals to provide appropriate
care, which would relate to workforce development in an area. Thank you. So, what everyone is putting in the chat and
thanks again for your participation. They’re rolling in now, and we don’t have
time, unfortunately, to go in and read all of the responses, but a lot of what’s being
discussed in the chat relates to the stress that can be caused for people. So, things like lack of access to transportation,
lack of access to mental health services. These things can create stress on the body,
which can have both mental and physical health impacts. So, what we have on this screen here is just
an example of some of the social determinants that people may experience in their communities
that cause stress and create allostatic load stress on the body for individuals, including
individuals with mental health challenges and serious mental illness. So, these stressors include things like unemployment,
being overworked and underpaid, lack of access to healthy food stores, Lack of community
resources, violence, crime, community trauma, poverty, racism, institutionalized oppression,
micro-aggressions, lack of social capital. Somebody mentioned it on the screen in the
chat, inadequate transportation, that’s on here. Lack of affordable housing, confrontations
with landlords. These are all different aspects of environment
that can cause stress for individuals. And so, again, today we’re going to talk about
the protective factors that communities and individuals can implement and some real life
examples of some healing that has gone on in communities, so that these different layers
of stress caused by social determinants are not on something that can lead, or hopefully
less likely to lead to adverse community experiences in an area or toxic stress or just individual
levels of stress, which impact wellness and mental health. So, for me that’s all I’ll say for now because
I’m really eager for everyone to be able to hear from Ruben and Richard. So, I will wrap up there. Thank you. Jasmin Brandow: Thank you so much Crystal. And now let’s talk with Ruben about the
various events and experiences and the impact that they might have on individuals with serious
mental illness. Ruben Cantu: Great. Thank you, and I was getting a little eager
there. So, good afternoon, good morning everyone. My name is Ruben Cantu, and I’m with Prevention
Institute. Prevention Institute was founded about 20
years ago as a focal point for primary prevention or preventing illness and injury before it
has a chance to occur. We are based in Oakland, California, and we
have offices in Las Angeles and in Washington D.C. as well. And our work is really based on viewing community
as the unit of change in these kinds of strategies. And community we recognize also has the broadest
potential for impact, as well. And to kind of dive a little bit deeper into
what I actually mean by that, we know that the environment can have an impact on illness
and injury directly through exposure to unhealthy soil, water, and air. But the environment also impacts our behaviors,
such as through some of the things that we just mentioned, access to safe places to connect
to our neighbors, availability of unhealthy products in our communities. And, as an example, one of the ways, that
this kind of shows up for folks is in housing. And this is a photo of some rural housing
in Florence, South Carolina, where we’ve been doing some work. And at first glance, this housing seems to
be poor, might not contribute to people’s wellbeing right? I mean, It looks very run down. But at the same time, as we’re looking at
the things in our community environment that impact our health in negative ways, there’s
also some positives and some protective factors that we can point out that will lead us to
think about how we can make changes in the community environment to protect us and to
help us heal and to help us get healthy. For instance, in this photo, you’ll notice
that most of these houses have front porches, which look like they’ve been added on after
the housing was built and probably in an attempt to have a place for people to congregate,
to talk to each other, to build those kinds of connections with their neighbors. Other things folks have pointed out when I’ve
shown this photo is that there are satellite dishes. So, people use that as a way to stay connected,
to look for entertainment in their world. And then another thing that somebody’s pointed
out is there’s the trash bin by the side of the house, which shows that people are actually
probably taking pride in their place and making sure that it looks clean and welcoming to
folks. And many of these unfair, unjust, and unhealthy
community conditions really reflect the systematic production of inequities through both a legacy
of overt discrimination on the part of policies and practices historically, as well as current,
present day practices and policies of public and private institutions that continue to
perpetuate a system of diminished opportunity for certain populations. And so, this graphic here of these gears in
this diagram, shows how some of the factors that have produced inequity, in this example
particularly in the built environment and land [inaudible 00:20:46] system are interrelated
and exacerbate one another. These forces most often conspire against people
of color, people of low income, so diminish opportunities and outcomes. But the production of inequities also marginalizes
other groups based on income, social status, where they live, and other additional factors. And really, to summarize, health inequities
have been produced over time. That’s something … Health inequities don’t
just pop up unprompted. They’re really the consequence of policies,
practices, and procedures across multiple determinants of health. A lot of times, the example most people turn
to and discuss when we talk about this, is the historical practice of redlining in the
housing market. And that’s one of the places where the after
effects of those policies being put in place is most obvious. Inequities are also fueled by norms or shared
values within sectors and institutions. They kind of get perpetuated that way. Bias, discrimination, and institutional racism
contribute and exacerbate those inequities. But there is a pathway to produce equity,
and strategic intervention points and pathways to produce healthy equitable communities do
exist and we’ve seen them in practice. And this is the kind of work that really needs
to take place across multiple sectors. And, there is also a connection to Adverse
Childhood Experiences or ACEs, which a lot of folks are familiar with. And the kinds of Adverse Community Experiences
and events and community trauma that we’re talking about, really increases the risk factors
that make ACEs more likely to occur. So, adverse community experiences can be considered
to trauma across the community as a whole, impacting people across the lifespan. And community trauma is a risk factor for
community violence, which can increase exposure to ACEs. And community trauma also reduces the protective
factors for ACEs exacerbating their impact. For example, communities with high rates of
trauma are compromised in their ability to be part of effective community improvement
strategies. And community trauma compromises social networks
and support, which is a factor against toxic stress. And so, there’s a lot going on in this graphic. But really what I want to talk about here
is the fact that Adverse Community Experiences really do impact and influence community trauma,
which, again influences and impacts Adverse Community Experiences, and it’s a mutually
reinforcing cycle. When we talk of violence in our communities,
we’re actually talking about several types of violence. One of those is structural violence, which
Crystal mentioned earlier during her presentation. And this is the way that some of the structural
drivers and systems in our communities end up harming folks. So, for instance, the example of housing. The housing market ends up harming people
through redlining, unaffordable housing, unsafe housing, and other things. So, some of the examples of structural violence
we have up here a residential segregation and segregation from opportunity, redlining,
gentrification, and displacement. Disproportionate toxic exposures. We know that a lot of times low income communities
sprout up around places where there’s harmful toxins, poor food systems, poor transportation
systems, disinvestment. All of these things are forms of structural
violence. And when put together with other forms of
violence, gang violence, sexual violence, fear of violence, and loss from violence,
those things combine to form these Adverse Community Experiences, which contribute to
and exacerbate trauma at a community level. And this graphic here, which again, is also
a little bit hard to see because there’s a lot going on, just kind of shows the productions
cycle of Adverse Community Experiences. So, you’ve got structural violence and interpersonal
violence up at the top, which impacts the individual. That individual is a part of a broader community. And the community is made up not only of people
that are dealing with their own traumas as a result of exposure to structural violence
and interpersonal violence, but the community itself as a whole shows some symptoms of trauma
itself in the form of intergenerational poverty, unemployment, disinvestment, disconnected
relationships, destructive social norms, deteriorated environments, the availability of unhealthy
and dangerous products and public spaces. So, all of those things together form this
cycle of the production of community trauma. But, and I have to note here, that everybody
has their framework for looking at the community environment, the social determinants of help. And this is Prevention Institute’s. And, as context, I just want to say, as we’re
looking at community and community trauma, we based that work off of this framework. Prevention Institute identified key community
determinants of health that are the most prominent factors in communities that influence health,
safety, and equity outcomes, including mental health, to determine which community conditions
were most strongly tied to the medical conditions with greatest disparities. These determinants were clustered into factors
in PI’s THRIVE framework or Tool for Helping Resilience In Vulnerable Environments. This framework groups 12 community determinants
of health and safety into these three interrelated clusters you see here. The People cluster, or the social cultural
environment, the Place cluster, or the physical built environment, and the Equitable Opportunity
cluster, or the economic and educational opportunity environment. And, this work all emerged from research that
we did with and for the Federal Office of Minority Health. So, here you see the 12 factors, which include
things like social networks and trust, norms and culture, the look feel and safety of a
place, living wages and local wealth, and I think we can all agree that these are things
that really do influence our health and safety in many ways. Through our work with communities across the
country, we were able to identify the community determinants that most impact mental wellbeing
and trauma. And those are the ones that have the stars
next to them. It’s kind of different for every community,
you see, and a lot of times these factors really do interplay with each other in lots
of different ways. And so, these are the seven factors that have
the most impact on mental health and wellbeing, and they also align well with strategies to
address trauma in particular. And so, here’s a bit of a blowup of the symptoms
of community trauma that I talked a little bit about earlier. This chart shows the sample systems, which
emerged through interviews with practitioners in communities with high violence and were
included in the development of the original Adverse Community Experiences and resilience
framework that Prevention Institute put together. And they’re organized, again, by those three
clusters, Equitable Opportunity, People, and Place. And you can see some of the things I mentioned
earlier. These are the symptoms of how trauma manifests
in communities as a whole. So, intergenerational poverty, long-term unemployment,
relocation of business and jobs, limited employment, disinvestment, and so on. These are all the ways that we end up seeing
harm done to our communities through the community environment. And kind of on top of this, there’s also the
impact that the community environment has on wellbeing and mental illness through this
dual continuum that we’re showing here. So, different context leads to different definitions
and strategies for treatment. And the context for which an individual is
experiencing illness or wellbeing can be a very powerful reflection of population health
outcomes. Focusing on diagnoses associated with mental
illness ignores the breadth and depth of experiences. This framework builds on the thinking of the
Georgetown University Center for Child and Human Development. Examining mental health and wellbeing, along
a continuum is more consistent with the WHO definition of health, acknowledging that health
is more than the absence of disease or a clinical diagnosis. So, the framework elements here are based
on tenants that mental health and mental illness are on a continuum, wellbeing is on a continuum
ranging from strong to diminished. Elements on each continuum impact your position
on the other continuum, and community conditions really do impact your position on both of
those axes. And, one of the ways that we have seen that
trauma manifests, as we mentioned earlier, is also through natural disasters. Hurricane Harvey, which hit the Houston area
in Texas, its impact was sweeping. The areas many industrial facilities emitted
millions of pounds of access air pollution, floodwater swamp, highly contaminated super-fund
sites and carried bacteria into schools, homes, and businesses and left behind prolific mold. And this historic storm, which forced tens
of thousands of Houstonian to flee their homes, also clearly inflicted a heavy emotional toll. Impact of job loss and loss of wages, survivors
of traumatic events begin to experience additional symptoms like interpersonal changes like withdrawal,
irritability, and mood swings, a sense of isolation, trouble sleeping, confusion, separation
anxiety, frustration, and outbursts. And, in the face of destruction and despair,
it’s really necessary for people to take the time to mourn and to heal from their losses
and for communities to create safe spaces just for them to do so. That’s kind of the starting point for a lot
of this work. I think a lot of us really are familiar with
the concept behind this Institute of Medicine quote, which tells us how difficult it is
to ask people to change when their context, their communities and neighborhoods are affecting
them in many serious ways. And so, one of the ways that we can get to
solutions is to have systems start to work together. Here we have a graphic, which I’ll go into
a little bit more detail later, that really shows that these systems such as justice,
housing, community development, immigration, education, economy, among many others, really
do need to be working together to be able to build communities, build systems, and build
structures that allow people to heal and then put strategies together to address the traumas
that they’re dealing with. And, we really do need solutions from a few
different directions. We not only need the kinds of solutions that
are outlined in this graphic here to the right, things like restorative justice and healing
circles, creating safe public spaces, investing in parks, housing, and transportation, rebuilding
relationships and networks, at the same time that we’re also looking at individual level
strategies like trauma, informed care, and mental health services to be able to reduce
individual and community level trauma and reduce the risk of violence and the threat
of violence. And, one example of a community that’s using
this approach is the San Jose Peace Partnership in East San Jose, California. It’s one of the eight communities that are
part of the California Accountable Communities for Heath Initiative, and they’ve been using
this framework to focus on community level change strategies and provide a structure
for expanding the focus to address multiple forms of violence. They plan to do things like in-depth training
on the concepts around community level trauma and primarily to service providers, so that
they understand that the work that they need to do needs to focus beyond just the individual
and actually look at changes that need to happen within the community environment to
provide people a place that actually will support their healing. And, I’ll go into a little bit more detail
about some other strategies a little bit later on during the webinar. But, to kind of close off my part of the presentation
here, there are also emergent measures to track community resilience, which supports
an emphasis on measuring what communities are trying to achieve rather than measuring
the scope of the problem. And so, looking at how communities have implemented
strategies for living wages, and the level and number of people receiving a living wage
is an important measurement. Looking at graduation rates, looking at the
stability of businesses and schools, looking at how murals and art and other cultural or
artistic expression manifests in communities, those are all things we could be looking at
to measure how we’re building resilience rather than what the problem is. So, we’re going to do anther poll question
and look at some of the strategies for mitigating the effects of toxic stress. So, if we can take a minute or two to just
select from the responses you see on your screen. So, strategies for mitigating the effects
of toxic stress and community trauma include a) being culturally responsive, b) recognizing
strengths and resiliency, c) encouraging involvement in community action, or d) all of the above. So, take a minute or so to go through. You should see the poll show up on your screen,
on the right hand side of your screen. Select your answer and click submit in the
lower right hand corner, and once we get a good number of responses from folks, we’ll
be able to take a second and see what the results of the poll are. Hopefully this reflects some of what you’ve
been hearing and you’ll actually be hearing a little bit more about some of these strategies
a little bit later on in the webinar. So, again take a minute, select a choice here
around being culturally responsive, recognizing strengths in resiliency, encouraging involvement
in community action, or all of the above. Okay, so we’ve closed the poll, and we should
have results in just a second … And it looks like most people, or it actually
looks like almost everybody selected all of the above as ways or strategies for mitigating
the effects of toxic stress. Great. Thank you everybody for participating in that. Jasmin Brandow: And thank you so much, Ruben,
for everything that you offered and shared, and now we’re going to shift our conversation
toward strategy for mitigating the effects of toxic stress and community trauma, and
we’re going to talk with Richard. Richard Smith: Good Afternoon, everyone. So, first of all most thank you, Ruben, for
your excellent presentation on the information that you provided. It ties in really nicely with the work that
we’re doing here at Common Justice, and more specifically, through Healing Works. So, just really quickly about Common Justice. Common Justice is an organization that was
founded about 10 years ago with the focus on developing and advancing solutions to violence
that transform the lives of those harmed and focused on fostering racial equity without
relying on incarceration. And, so, locally the way that we do that is
that we run the first Alternatives to Incarceration Program in the country that focuses on adult
violent felony offender, or convictions, folks with convictions. And then nationally what we do is we leverage
the information and experiences that we learn through Alternatives to Incarceration Program
in order to transform the justice system, and really hold people accountable and break
the cycle of violence and ensure that people feel safe and secure, but ultimately to ensure
that people can heal and thrive. And, a couple of the principles, the way that
we process this and the way that we do this, is we first start off with a survivor sensitive
approach, and meaning that oftentimes the survivors are left out of the criminal justice
system’s process, oftentimes with the exception of a Victim’s Impact Statement. And, so, we focus on having those who are
survivors be at the center of what this process looks like in order to restore the harm that’s
been caused to them, and also it’s accountability based. We have accountability based response to violence. Essentially, we realize that we’ve often associated
accountability and punishment as being one and the same, but in essence they aren’t,
and we know that incarceration doesn’t hold someone accountable. You can do a substantial amount of time and
never engage in the process that needs to happen in order for you or the person to feel
like they are accountable and figured out reasons for why some of the behaviors that
they’ve done have happened. And, safety driven, right? Realizing that our system has not been effective
in making us more safe, and so how do we develop solutions? What are some of the practices that are happening
throughout the country that are more effective in making folks feel safe and restoring communities,
such as Restorative Justice. And, I think the most important thing, as
it wraps around all of these, is that we realize that certain groups within our community have
been denied access to equity, and so our approach is a racially equitive response to violence,
as well. And, so, Healing Works actually evolved from
learning the lessons from our Alternative to Incarceration Program and, most importantly,
realizing that hurt people hurt people. And, so, we’ve found that the majority of
the responsible parties who are in our Alternative to Incarceration Program had already been
harmed themselves by violence and trauma in the past. And, that trauma and that violence had never
been really addressed. And, we also understood that healed people
heal people, and so we set out to figure out who was providing the healing services throughout
the country. And, so, we organized a group to convene and
discuss, and this group consisted of folks throughout the country who were providing
healing services more specifically to boys and men of color, because the thing that we
realize is that boys and men of color were the most likely to be victims of violence
and crime and exposed to trauma, but the least likely to receive the services that they need
to heal from the trauma and the violence that they experienced. And, so, our focus was on boys and men of
color. And we had this convening to determine what
are some of the principles that we found to be most effective and the work that folks
were doing throughout the country in supporting the healing process of boys and men of color. And, that’s where we came up with our framework. And, so, that framework consists of addressing
historical trauma head on, realizing that there’s this history of historical trauma,
as well as historical racism that impacts the lives of those who have been or actually
exacerbates the experience of interpersonal trauma in a way that boys and men of color
experience kind of uniquely. We also realized that we needed to a strength-based
approach to this, recognizing the value and the strength that come from those who are
survivors and who have been impacted by trauma and violence bring to this discussion, bring
to the work. Also, realizing that leadership needs to come
in the form of those who are survivors, as well. And, so, these are some of the principles
that we determined as a result of just reaching out to the community, guided the work of those
who are really committed to healing boys and men of color. And, so, one of the things that recently happened
with Healing Works is that we since shifted our focus, realizing that trauma doesn’t happen
in a vacuum and healing doesn’t happen in a vacuum, and therefore, there needs to be
ally shift, as well as mutually supported healing that happens between all those who
are historically marginalized, more susceptible to violence and trauma … to being exposed
to violence and trauma, and often denied the healing support services that they need from
violence and trauma. And, so, we’ve shifted to focus on healing
equity. And, so, one of the things that we believe
is that healing equity will exist when everyone who’s experienced violence, particularly those
who have been historically marginalized, have the resources, relationships, and power that
they need to be well and to survive. And, I think that the piece to emphasize here
is the power component, and I’ll talk a little bit more about what this means, but the power
component relates to systems change work, specifically the systems change work that
needs to be done to reform or change systems and institutional approaches that have been
historically discriminative and historically racist and denied boys and men of color and
other historically marginalized groups access to the services that they need to heal and
to thrive and to be well. And, so, the world that we envision is that
people of color will have the collective power and the capacity they need to ensure healing
equity and that systems and structures act in support of every community’s inherent right
to heal. And, what we’ve found is that oftentimes the
healing of boys and men of color is contingent on some type of violence reduction or the
reduction of crime, essentially stating that boys and men of color need to be healed because
it will reduce the likelihood of them committing any type of crime or hurting someone else,
and not being healed for the sake of their humanity. But, we also noted that oftentimes that’s
approached and used for many other historically marginalized groups. And, so, one of the things we were able to
do through our partnership with their Institute for Justice, is become a member of this National
Resource Center for Reaching Underserved Victim’s of Violence. And, the National Resource Center for Reaching
Underserved Victim’s of Violence is funded through the office of Victim’s of Crime, and
essentially what they did is they pulled together a group of leaders in the field of victim
services who worked with research identified underserved populations. Namely who worked with children, older adults,
people with disabilities, the LGBTQ community, men of color, people who were formally incarcerated,
and also people from historically underserved communities, such as Native communities, women
of color, and religious minorities. And, each one of these groups consisted of
experts throughout the country that then individually conducted a national Listening Tour, where
we interviewed hundreds of folks throughout the country, conducted many focus groups,
to really get an idea of what are the strategies that are most effective with each one of these
populations, engaging them, providing healing support for them and services for them? What are the barriers that have been identified
that interfere with these organizations in providing services to this member of these
identified underserved populations? So, Common Justice, we focus specifically
on boys and men of color, and we were able to conduct 44 interviews throughout the country
and five listening sessions where we engage in conservation activists, organizers, direct
service providers, healers from nontraditional programs and organizations, to really get
a better feel of what they thought those effective strategies were, what wasn’t working, and
what are some of the barriers that interfere. And, so, what we learned from our national
Listening Tour were essentially that the factors that contribute to boys and men of color being
underserved are some victim services agencies needing to create the space for male survivors. We heard that from mainstream victim provider
services throughout the country, which often focused on women and domestic violence survivors,
did not create a space that was welcoming for men, and then more specifically, did not
create a space that was welcoming for boys and men of color. We also heard that victim service providers
should be more racially and ethnically-diverse to reflect the population that they’re serving. This is not new information to anyone who
is listening, but I think we took it to the next level in not only just recognizing the
importance of racial and ethnic identify and that reflecting the population that’s being
served, but also within those different racial and ethnic groups, there’s this cultural identity
that exists, as well. And, we found that it was important for people
to be connected to the culture and to the community of the folks that were being served. We also found that there were populations
among boys and men of color who were even more underserved, and this is something that
was really salient when we interviewed folks in Boston, specifically folks who run a hospital-based
trauma response center, where there were working with members of the Cape Verdean Community
and the Haitian Community, and they were starting to make headway with increasing the services
and being more effective in servicing African American and Latinos males within the City
of Boston, but they faced tremendous challenges reaching out and servicing members of the
boys and men of color of the Cape Verdean Community and the Haitian Community. And, one of the things that resonated with
me, because I actually conducted one of the interviews, was that when talking one of the
coordinators from the trauma response center, she said that she went out to the community
and tried to engage folks from the Haitian Community, and what she learned is that there
was no word in Creole to describe trauma. And, that resonated with me because if you
can’t describe the problem according to the way that we have been describing the problem,
it’s really difficult to develop a solution. And, so, we started to realize that trauma
is not a universal language that everyone can identify with. But, what we also did realize is that healing
was a universal language, and that folks understood what healing meant. They may not have understood what healing
meant on a psychological, emotional, or spiritual level, but they knew healing. And, so, with that, we realized that there
was some effective strategies for engaging populations, and in kind of alignment with
what I just said as far as reaching out to the very community that the population reside
in and being connected. Not just necessarily going to these communities
and providing services, but living within these communities, having the opportunity
to interact with people on a daily basis. So, then when you show up to support them,
it’s not done as an outsider coming in, but it’s someone that they’re familiar with. And, honestly, we know that that wasn’t a
strategy that everyone could employ, but we recognize the value and benefit of that as
it relates to the listening chore and the folks that we interviewed throughout the country. And then we also realize that there were various
ways in which healing happened that weren’t necessarily connected to therapy. Healing was also happening in the form of
engaging survivors in activism and organizing because one of the things we learned is that
is trauma disempowers. Part of the healing process needs to include
empowerment. And, so, we found that through organizations
that were engaging boys and men of color in activism and organizing efforts to change
some of the systems and policies that exacerbated their experience of violence and trauma, it
was empowering and ultimately, it was healing. And, so, now we’re at the point of developing
our implementation of initiative that evolve from our findings from the listening sessions,
and the two initiatives that we came out with is there is a tremendous need for a holistic
healing framework that accounts for the various ways in which healing happens especially for
boys and men of color. So, what we realize is that some organizations
were really effective in providing the clinical, therapeutic healing support, whether it’s
trauma inform, CBT, some were really effective in connecting young men of color with credible
messengers who may have had a level of personal experience that allowed them to connect and
identify with the young men of color who have been impacted by violence and crime of a different
level that was different from, let’s say, the therapist. And then, also again, how activism and organizing
and advocacy contributes to healing. And, so, one of the initiatives for us to
develop is this healing framework that accounts exactly for that, cause we realize that trauma
doesn’t happen individually. It’s not an individual experience. It’s often a collective experience. And, so, approach to healing needs to also
be a collective process. And, so, just kind of coming off the backs
of some of the work that Dr. Shawn Ginwright did out in San Francisco, and his focus on
a healing centered engagement approach which we definitely found to be true from our Listening
Tour, is that trauma did have an impact on the field and it informed how we view the
impact of violence and trauma on people, but it also had limitations. The Trauma Informed Care approach had limitations. The Trauma Informed Care didn’t encompass
the totality of the experience of people, and Trauma Informed Care was like the equivalent
of saying that you are the worst thing that happened to you. Trauma Informed Care incorrectly focused on
the impact of trauma on the individual, but it didn’t focus on the collective impact of
other factors that exacerbated the experience of trauma. And, so, the other things that he focused
on and we’ve discovered from our Listening Tour, is that it’s not just a matter of saying
what happened to you and pathologizing the experience, but recognizing their resilience
and asking what’s right with you, and figuring out how to engage those who have been impacted
by trauma and violence in a way that’s from their strength and their resilience, knowledge
that comes from their insight from the experience and the process. And this kind of relates to the holistic healing
approach, or what Dr. Ginwright calls the … He calls his the Healing Centered Engagement
and developing strategies for a holistic approach to healing boys and men of color impacted
by violence and trauma. One of the other things that I thought was
really relevant to this conversation that Ruben touched on, the community trauma, is
just recognizing the impact of historical trauma on the lives of historically marginalized
people, and I liked his definition by Dr. Karina Walters, and she describes historical
intergenerational trauma as an event or series of events perpetrated against a group of people
in their environment, namely people who share a specific group identify with genocidal or
ethnocidal intent to systematically eradicate them as a people or eradicate their way or
life. And, if you think about the historical experiences
of boys and men of color and communities of color in general, you realize that boys and
men of color, especially African Americans, in country have experienced a tremendous amount
of historical trauma. And, the other ways that we understand historical
trauma, to make that connection with historical trauma, is that it’s accumulative exposure
to traumatic events that not only effect the individual exposed, but continue to effect
the subsequent generations. And, then when it’s untreated, it’s passed
down from one generation to the next after it’s internalized. And, so, it’s interesting when we look at
the newer science as it relates to epigenetic and the transmission of traumatic experiences
from one generation to the next and the research around the psychobiological aspects of trauma,
we see the ways that historical trauma impacts one generation to the next without them even
knowing and starts to manifest itself in current behaviors. And, what we realize is that sometimes when
boys and men of color are trying to explain something in a way that doesn’t make sense
to us, especially like their behaviors, it may be associated with that phenomenon. It may be associated with the psychobiological
piece that we’re learning more about, where the research that was conducted with Holocaust
survivors showed that not only did the Holocaust impact those who immediately survived, but
it also was passed down to their next generation. And, so, just in conclusion, one of the things
that we discovered that was also extremely important, is this need for healing justice
and this is really related to the stuff that I was talking about earlier, as it relates
to the systems change work. And I like the quote that Audrey Laude made,
and it kind of really captures the significance of healing justice, and it goes “Caring for
myself is not self-indulgent. It is self-preservation, and that is an act
of political warfare.” And so essentially, healing justice refers
to a paradigm and a set of practices that invites practitioners to heal themselves,
at the same time by trying to heal the world. And, that was one of the most resounding,
consistent messages that we heard from our Listening Tour, is that those who are out
in the trenches, whether they were engaged in direct service provision and supporting
the healing process of boys and men of color, or they were involved in systems change work
or organizing or activism, they were exposed and continued to be exposed to tremendous
experiences of oppression that lead to their re-traumatization. And, so, the need for healing justice, or
being committed to this healing practice became paramount. And, so, there’s this huge effort that’s being
pushed by activists, by healers and social service providers, to make sure that those
who are the most connected to these problems are engaged in that healing process for themselves. And I also say that I like to think that this
is much more than just self-care. It’s also communal care. It’s recognizing that we need to also be responsible
for supporting the healing process of each other who are committed in this movement. And, so, with that, my time is up. I’ll say thank you, and I’m looking forward
to the Q&A. Jasmin Brandow: Thank you so much, Richard,
for offering so many points on a healing formed or healing justice framework. And now we’re going to transition back to
speaking with Ruben a little bit more about community activation. Ruben Cantu: Great. Thank you. And, I’m going to be talking a little bit,
kind of continuing on the same theme, I’m going to be talking about an initiative that
Prevention Institute works on called Making Connections for Mental Health and Wellbeing
Among Men and Boys. This initiative is funded and supported by
the Movember Foundation, which is the largest global men’s health funder, and this initiative
is made up of 16 sets across the US that are working to improve mental health and wellbeing
among men and boys of color and military service members, veterans, and their families, through
the development and implementation of upstream community level strategies. Prevention Institute manages the project and
provides technical assistance and coaching to these local coalitions and the University
of South Florida is the Initiative Evaluator. So, when we first announced this Initiative,
we had 230 applications for the work, which just really goes to show how many people really
want to see these kinds of strategies implemented to address the mental health and wellbeing
needs of men and boys of color. We ended up narrowing it down to 16 sites
who are part of a national community of practice. They’re very diverse in terms of the population
of focus, where they’re located, and who is leading the work. Lead agencies include community based organizations,
health departments, health systems, and healthcare providers. And, so, at kind of the inception of the project,
the Movember Foundation actually asked us to conduct a landscape analysis on the current
landscape of men and boys mental health. And, so, when we did that, we did a literature
review, we conducted interviews with experts to develop this analysis. Some of the findings are listed here. So, around limited notions of masculinity,
which kind of keep men and boys from seeking help, the fact that men and boys of color
are disproportionately impacted by mental health needs and by trauma, as well as military
service members, veterans, and their families. Some of the other findings were that we’re
really not focusing on prevention. A lot of the focus when we’re talking about
mental health, wellbeing, and trauma, is focused on treatment. But, there are a lot of community and culturally
rooted practices that are emerging that support healing and mental wellbeing, and we also
found that resilience is that critical protective factor that can be catalytic for community
wide prevention approaches. And, the initiative kind of works on focusing
on these four shifts. So, I think a lot of times when we talk about
mental health, we’re actually talking about mental illness, and, so, we need to make the
shift from having mental health meaning mental illness to an emphasis on wellbeing and resilience. We need to shift from a focus on treatment
only to one that also includes upstream prevention strategies. Shifting from a focus on the individual only
to one that also focuses on transforming communities, and from a one-size-fits-all approach to a
more equity focused approach that applies a cultured and gendered lens to work. The work of this initiative is also supplemented
and supported by the work that we’ve done on Adverse Community Experiences and Resilience. I talked a little bit about this earlier. Through Prevention Institute’s work with large
cities across the country that are putting into place a public health approach to preventing
violence, we kept on hearing from folks that trauma not only manifests in individuals,
but that it manifests at a community wide level. So, we did literature review there, as well,
to develop this framework with the support of Kaiser Permanente and developed in conjunction
with our partner at University of California San Francisco, Dr. Howard Finderhuis, to put
together this framework for how to address Adverse Community Experiences and how to build
resilience. And, just recapping the symptoms of community
trauma that we saw manifesting across the communities, these are the things that people
were talking about when they were saying trauma manifests at a community level, as well. And these are the things that are kind of
preventing people from putting into place the effective strategies to address not only
trauma, mental health, wellbeing, but also other sorts of health promoting strategies. And it’s important to really address this
level of trauma, because it’s really difficult to do anything in a community that is undergoing
this kind of stress, this kind of adversity without having a chance to heal first. And, so, this graphic will be familiar. I shared this earlier, but now I want to focus
on a different aspect to this is that a lot of the work that we’re talking about building
in some of the examples I’m going to share and some of the things that Richard talked
about, really do focus on healing first. That’s why healing is at the center of this
graphic. Communities and individuals need an opportunity
to heal before they can actually work on any of the other things that they need to do to
address violence, to address other forms of trauma that they’re facing in their communities. And the strategies do need to branch out among
the three clusters that I talked about earlier, around the social cultural environment, the
[inaudible 01:08:12] environment, and the environment of opportunity, while at the same
time working with systems to put into place, the supports needed to be able to advance
this work. In addition to that, through the work that
we’ve done with the Making Connections Initiative, another set of concepts emerged that we recognized
and they recognized as being the core elements needed for people in communities to be able
to flourish emotionally. They interplay with each other and along with
the other community determinants of health in a way that makes them more specific, and
so we’ve got belonging and connectedness, control of destiny, dignity, hope and aspiration,
safety, and trust, all being things that a community needs in place in order to be able
to do this work. And, so, when applied to looking the community
determinants of health, for example, housing, which is an example that keeps on coming up
in our work, when we were talking to people about what would be needed to improve wellbeing
and to reduce levels of stress in their community, housing was an issue that kept on coming up. But, it wasn’t just housing. It was housing that was safe. It was housing that people felt connected
to and they felt they belonged, housing where they were treated with dignity. Housing that they could trust would be there
for them, and so, we kind of see how these pillars interplay with the other kinds of
needs in the community environments that need to be addressed. And, so, again, as I mentioned, healing is
the starting point for community agency. It’s necessary for effective, collective action,
to be able to find solutions that improve community health. Individual approach to healing include things
like trauma, informed care, and mental health services, but at the community level, healing
takes a couple of different forms, including healing circles and vigils. It includes restorative justice practices,
community dialogues that acknowledge transgressions and identify solutions for moving forward. And we see examples of this kind of collective
communal healing all the time. Just yesterday here in Oakland, there was
a group, a gathering, a vigil to commemorate the young lady whose life was lost a couple
of days ago on mass transit. So, that’s one of the ways that people do
this. One of the examples that I want to call out
in a little bit of the time that I’ve got left is an example from the site that we’re
working with in San Diego, the work that’s being led by United Women of East Africa,
which is a group that’s working with East African refugee boys and men of color. And, when they were asked what they needed
to be able to address healing and to build resilience in their communities, they said
that they needed a space to be able to come together to kind of tear off the masks that
they have to wear at home, that they have to wear in school to try to be something that
people will welcome. And so many of these young men have faced
discrimination, racism, Islamophobia, in a country that they at first thought was going
to be welcoming and open to them. And, so, they decided to build out this psychosocial
hub that they call it, where they come together to just connect to each other. They have games they can play. They have guest speakers who come in to talk
to them about developing workplace skills, about educational skills, and as they’ve kind
of come together and built this cohesive network of young men that show up on the evenings
and the weekends, they’re actually starting to include advocacy training so that these
young men can then go out and do advocacy work with their local city councils, boards
of supervisors, to advocate for the other things that they see as being huge needs in
their communities. For example, anti-displacement policies related
to housing. I’m running short on time, but I just wanted
to share really quickly some of the other strategies that we talk about, or strategies
among the people clusters. So, increasing civic participation, supporting
intergenerational relationships, advancing positive norms, and kind of changing the narrative
and changing the narrator of the stories that come out the communities, and reconnecting
with cultural identity. Those are all very important things. In Chicago, a group that we’re working with
out of Sinai Health System, called the Legends of Lawndale, has developed a Sports and Play
Program for young boys in this community that has super high rates of violence. And, they bring the young men together once
a week to play a sport; basketball, kickball, soccer. But, they also incorporate into it healing
circles at the beginning and at the end of each of the sessions, so that the boys can
talk about the things that they’re seeing in their community that are harming them and
turn to each other for support . Here are some of the other strategies. I’ll just kind of scroll through these really
quickly so I can come to an end here. Strategies around the actual place in the
community, reclaiming land spaces and public places, arts and cultural expression, stable
housing with dignity, safe and supporting places for regular gathering and coming together. We can share more information later about
an initiative in Honolulu that has opened a bike shop as part of a community health
center so that they actually have a place for the young men to come together, talk to
each other, share their struggles, and actually learn skills around building and repairing
bikes. And, some other strategies in the community
around opportunity, workforce and economic development, restorative justice practices,
resident ownership of businesses, and strategies across systems, so having systems actually
do their work from a trauma-informed perspective, working on public health solutions to police
community violence, and power sharing. Participatory budgeting is one that we’ve
been hearing a lot from folks, really taking an effort to include community members in
civic budgeting for cities and counties. And, I wanted to close this by just sharing
the elements of a resilient community. We’ve kind of talked about the things that
need to happen in communities to be able to build resiliency. We need to have strong social networks and
trust, community engaged into developing solutions, access to healthy food and products, preserved
safety, safe affordable housing, thriving arts and cultural expression, high quality
education, living wages and local ownership. These are the elements of a resilient community
that will not only be able to bounce back from the trauma that they’ve been faced with,
but will also be able to push against it to try to make change happen so that their own
lives and lives of those that will come after them can be better. And, I am going to pass it back over to Crystal. Jasmin Brandow: Thank you, Ruben, and this
is actually Jasmin who’s going to step in for just a moment. I just wanted to thank you for sharing more
examples of where we’re asking, as Richard put it, what’s right with you, and how that’s
transforming individual’s relationship in communities. Now, this is a conversation that we always
wish we had more time for, and for many of us, these are conversations that are ongoing. In the interest of time, we have a couple
of questions that we’re going to be able to take look at, and the first question is, what
is the process for changing personal views and practices which lead to and promote these
disparities? So, a couple of things came to mind when we
saw that question that we thought to share, and some of it was already talked about, and
so, the person asking may have received some responses or some ideas that can help answer
that question. A few other things to consider are practices
around self-care and self-reflection. Many of us in this work believe that there
is work to be done at the individual level, which of course affects us interpersonally
and how we relate to one another, as well as for organizations or for communities at
that level. There are tools that exist for developing
self-awareness of biases, of our belief systems, of the structures that we’ve inherited that
can be rather limiting to help open us space for more opportunities for connection, and
as we heard from our panelists, those opportunities for connection for belonging, for all of us,
are ways that the healing process can begin. And I just want to check in before we move
onto our next question and ask Richard. Did you have any other thoughts that you might
want to add to the question of what is the process for changing personal views and practices
which lead to promote disparities? Richard Smith: Yeah, I think you nailed it
with the importance of being continuously engaged in our own healing process. Those who do the work and, as much as we need
that support and we need that process to be consistent in our own lives just as we would
want to promote that to happen in the lives of those that we serve. Because, the fact is, we can’t expect to go
through the systems ourselves and come out unscathed. And, so, we’ve been impacted by the same systems
of oppression, the same traumas that many of the people that we’re working with have
been effected by, and so I think the start is really being committed to our own healings
process. Jasmin Brandow: Yeah, thank you. Ruben Cantu: If I could, one thing that I
would add to that is, a lot of times it comes down to accepted norms in a community, and
it also comes down to the narrative and the way people talk about communities, and that
exacerbates the disparities in lots of different ways, and I think by shifting the conversation,
and we often say, “Oh, we need to change the narrative. We need to change the narrative.”, but, we
can’t change the narrative till we actually change the narrator, and let people be able
to tell their stores. For every story that we hear coming out of
community, a violence riddled community, there are so many other stories about those kind
of positive adaptations to adversity. When I lived in Washington, D.C., for 12 years
in the late 90s and early 2000s, I lived in a historically African American neighborhood,
the U-Street Corridor, and before it became what it is today when it’s been super gentrified,
and on weekends, my neighbors would pull their sofas and their televisions out to their front
yards and hook up long extension cords and they would set up and watch the game out on
their front lawn and create gathering spaces for people to come out. The older men in the community would always
sit out on their porch and people watch on the community because there was a corner that
was notorious for drug activity, and so having folks be able to come out, reclaim the space
and have it contribute to making it a safe space for people to gather and to be a part
of the community, really goes a long way to changing the perception and changing the way
a neighborhood is talked about, and that starts to shift the norms in that community, which
can contribute to healing and building resilience. Jasmin Brandow: Ruben Cantu: Oh, that’s such an important
consideration, as well, and such a beautiful addition, so, thank you for that, Ruben. And our next question is actually for you. How has structural violence been documented
other than through observation? Is there research that can make the links
of how the type of violence contributes to trauma available? Yeah, that’s a great question. Thank you. There’s a lot of research out there about
how structural violence, structural racism, structural trauma, has really impacted communities
and had an impact on health and wellbeing and safety. One of the most important one, kind of was
the starting point for a lot of this work, was the work that was done around the initial
ACES study that CDC and Kaiser Permanente put together, and the field has only grown
from there. So, there is plenty of research out there. One of the things that I can share with you
all to share with the audience possibly is links to the two reports that I referenced
in the presentation on Adverse Community Experiences and then a companion document, which is a
Frequently Asked Questions document on that that will link to some resources on the research
that’s been done about that. And, there is lots of research that’s been
done about how structural violence impacts communities, and now we’re kind of trying
to go in the other direction and figure out how do we actually measure the effects that
building resilience and putting these kinds of positive strategies into place impacts
communities in a positive way. So, I’ll make sure I share those resources
out so that they can be shared more widely with the participants and any sort of follow-up. Jasmin Brandow: That would be wonderful. Thank you. And, we’re soon going to be turning it back
over to Crystal to close out our time together, and Crystal, just to check with you, do you
have a sense of any research that might be available that could be supporting or learning
around this? Crystal Brandow: Yeah, thank you. Just to backtrack to Ruben’s comment. So everyone knows, please check your chat
box because the two publications that he mentioned, the links to them, I dropped them into the
chat box, so they are there, and we will also email them to attendees following today’s
event. I’m also adding right now the FAQ document. So, that information is there. So, please go to those links, download those
publications, and learn more about this topic if you’re interested. And, to echo Ruben again, there is an abundance
of research on this and it’s only becoming more of a popular area to explore and investigate,
and one of the recommendations that I will share with this group is if you have the availability,
if you check out the book The Social Determinants of Mental Health, by Dr.’s Michael Compton
and Ruth Shim, and throughout that book, there’s extensive evidence that supports links between
social determinants and mental health outcomes. So, Dr. Compton and Shim are the editors of
the book, so it’s a compilation of some of the existing research and findings. And I’ll drop that in the chat box, as well. And, that is just one of the many resources
available that does draw concrete connections, correlations, and causation between these
factors that we’ve been talking about today. So, that’s an excellent question and we hope
you’re able to benefit from some of the resources to learn more. Jasmin Brandow: Great. Thank you. Crystal, I think we’ll hand it over to you. Crystal Brandow: Yeah, thank you, Jasmin. We have one more question here and just about
two minutes to answer it, but this is one more question that I think might be of benefit
to some other folks on the line, so I’m going to go ahead and read this quickly and ask
Ruben and Richard if you have any experience. And, the question is about whether you have
experience working in communities that are rural and as a result of that rural nature,
maybe have been exposed to certain cultural viewpoints that could benefit the region,
and so how in your experience, and I don’t think this has to be just rural at all, in
your experience, how do you help people in communities to shape cultural view to be more
open to one that fosters well in. And we’ll have just a minute to answer this
one. Ruben Cantu: So, I can jump in really quickly. One of the examples that I had to cut out
cause I got a little long-winded, was we’ve been doing some work in 12 rural counties
in Ohio to try to help them look at a prevention and public health approach to the opioid epidemic,
and it is a little bit different, because I think traditionally when we talk about these
kinds of trauma, we’re talking about violence and interpersonal violence which we more often
talk about when we’re talking about urban settings. But, in these more rural settings, the conversation
turns more to the forms of structural violence in the form of disinvestment, in the form
of industry leaving communities and leaving people with very low income. A lot of social isolation, as people have
left those areas, to move to areas with greater opportunity, we find people whose nearest
neighbor is 20, 30 miles away, and don’t really have a place to connect and build relationship. So, it is kind of a different language. It’s a different perspective, and I think
it’s looking at things like social connection. I think it’s looking at things like loss of
jobs and industry low income, lack of really good resources for education, and how that
really ends up traumatizing people in a very similar way, which as we’ve seen in places
like Ohio and places like West Virginia and New Hampshire, has really led to those places
turning to things like opioids and other illegal drugs that has ended up harming them in lots
of different ways. So, we have a profile on the work that we’ve
done in Ohio, and that’s probably something that we can get on to folks as well. Crystal Brandow: Thank you so much, Ruben,
and Richard, in just a minute or less, do you have anything you’d like to add or are
you satisfied with ending like that? Richard Smith: Yeah. I think the other thing that I would also
add is the impact of mass incarceration that has not only hit urban communities hard, but
also rural communities, as well. And, I think that’s a huge, huge factor that
contributes to traumatization of a lot of people in rural communities, as well as those
communities being the primary place in which prisons are being built. So, being impacted by mass incarceration and
then having prisons in your backyard are definitely some factors that can contribute to trauma,
and I think really the systems change work to … I have a lot of friends who are working
to close prisons in some rural communities for that particular reason, to empower the
community and not have them feel as disempowered as they currently do, is something that I
have identified as an effective strategy, reducing the impact of structural trauma on
the communities. Crystal Brandow: Thank you so much. Unfortunately, we are out of time. I feel like we could spend another 90 minutes
talking about this, if not much longer. A full day, or if not, days. So, I want to say thank you again to Jasmin
Brandow, co-founder of Humankind Workshop, for moderating today’s discussion, than you
to Ruben Cantu from the Prevention Institute for joining us and sharing your expertise,
as well thank you to Richard Smith from Common Justice’s Healing Works for sharing the experience
and knowledge that you have on this topic area. It feels like the discussion was too short,
but we are out of time, so if you have additional questions, the contact information for today’s
speakers are on the screen. You can feel free to reach out to anyone directly
with any specific requests for information, and the event today was recorded, and so the
Webinar will be available to stream on SAMHSA’s YouTube channel, and in the meantime, we will
forward everyone a copy of the slide deck from today, as well as a Certificate of Participation,
and any resources that we shared in the chat box, like the documents from the Prevention
Institute, for example, we’ll email you those as well. So, thank you everyone for joining us. When you exit today’s discussion, a survey
will pop up. We ask that you please take the time to complete
that, let us know what you think about today’s presentation, if it was useful, and if it
applies to your work, and again, just thank you so much to our speakers for this very
detailed and fascinating conversation, and thanks to everyone for joining us.