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Class, alcohol, drugs and adverse childhood experiences in Scotland

January 14, 2018 by Carol Craig Leave a Comment

I recently had the privilege of seeing the documentary Resilience again, this time at a showing primarily aimed at MSPs in the Scottish Parliament.

For those who aren’t aware of the film and the movement growing up around it ‘Resilience: The Biology of Stress and the Science of Hope’ is an hour long documentary made by James Redford, son of the famous actor Robert Redford. It’s about the growing research on how Adverse Childhood Experiences (ACEs) affect not only children’s physical and mental well-being but their lifelong health as adults.

The film’s Scottish premier was in April 2017 and this proved so popular that in the subsequent months dozens of shows were held all over Scotland  – not just in the main population centres but also in the Highlands and Islands, the Borders and small towns in between. Many of these showings sold out within days of their announcement. Over two and a half thousand people have now seen the film in Scotland.

Behind all this activity are two determined and devoted women – Dr Suzanne Zeedyk, an American developmental psychologist and research scientist who has lived in Dundee for 25 years, and Tina Hendry, based in Ayrshire, who has set up an organsation called ReAttachment.

As some critics have pointed out, the film is a straightforward documentary – apart from some good graphic sequences on how children experience toxic stress, it’s mainly a series of talking heads and is more like a television programme than a film.

It’s the significance of the ACE research that gives the film its emotional power. Much of the information it presents can be gleaned from books and articles but, as Tina Hendry pointed out at the showing in the parliament, this isn’t something that many people are likely to do. More importantly,film screenings are powerful as they involve a shared experience and naturally lead to a discussion with others on what we should do.

I’m a fan of the film and think that it’s a great starting point for a discussion on ACEs. As it is only an hour long inevitably it cannot cover every important aspect of ACE research. Here are a couple of important points not picked up in the film  which could be explored in discussions.

Not a class issue

The first is about class, inequality and poverty. The ACE questionnaire asks ten questions about children’s experience of household dysfunction: were they hit, sexually abused, emotionally/verbally abused, or emotionally neglected? Did their parents split up, was their mother beaten up, did someone in the household abuse alcohol or drugs or suffer from depression or commit suicide? Was someone in the household imprisoned? And were their physical needs (for food and shelter) catered for?

Research by Bellis et al on the prevalence of ACEs in England shows that anyone, irrespective of class background, can suffer from ACEs but that those scoring four or more tend to come from poorer backgrounds. Even if people come from better off backgrounds ACEs can have a significant effect on their mental and physical health.  This means that ACEs affect people from all social classes.

The correlation between childhood adversities and class is therefore not straightforward: Those from poor backgrounds are more likely to suffer from high ACEs yet we can all suffer irrespective of our class background. Unless we acknowledge that complexity the tendency will be for professionals to ‘other’ ACEs and make the topic about poor kids.  On the other hand, if we don’t acknowledge the class dimension we won’t see the importance of ameliorating poverty to lowering the prevalence of ACEs.

The second point I would like to see given prominence to in discussions is alcohol and drugs – a major driver of ACEs. One of the doctors behind the ACE research – Robert Anda – has shown that if someone in the family misuses alcohol or drugs this then is likely to increase the number of ACEs as this can then lead to violence, emotional abuse/neglect, poverty and often sexual abuse.  The significance of alcohol and drugs to ACEs was not conveyed clearly in the film.

Scotland has a major problem with alcohol and drugs, and has for some considerable time, and this must mean that we are an ACE high culture. This is one of the arguments I put forward in my recent book Hiding in Plain Sight: Exploring Scotland’s ill health.

The success of Resilience in Scotland has not just taken the tour’s organisers by surprise. As no other country has engaged with the film in the way that Scotland has the filmmakers are also intrigued. It’s certainly worth trying to understand why the film has such resonance for us.  Resilience is a great educational resource and is opening many Scots eyes to the source of our health problems and what has literally been ‘hiding in plain sight’.

First published by the Centre for Confidence

 

 

Filed Under: Blog, Health, Policy Tagged With: health, mental health, Scotland

About Carol Craig

Carol Craig, chief executive of the Centre for Confidence and Well-being, is a trustee of Upstart. She is an author and series editor for Postcards from Scotland. Her latest book is Hiding in Plain Sight: Exploring Scotland’s ill health.

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