Re-politicizing Trauma: A Narrative Approach to Mental Health in the Heartland

Researchers propose a transformative strategy that emphasizes the role of narratives and social context in addressing childhood trauma and substance use.


New research demonstrates a fresh approach to addressing adverse childhood experiences (ACEs) and substance use, shifting the focus from biomedical approaches to trauma within the broader canvas of social determinants of health.

The study, published in the American Journal of Community Psychology, is grounded in efforts by local health departments in the Midwest aimed at crafting new narrative strategies to promote health equity and inform preventative efforts against ACEs and substance abuse. This comprehensive project commenced in Fall 2018 and was supported by $2.9 million in grant funding from major public health institutions.

Harper and his colleagues argue that while ACEs have been traditionally viewed through a trauma lens, focusing predominantly on individual experiences, this perspective may inadvertently overlook the broader social determinants of health (SDOH). Their work emphasizes that any effective approach must consider the complex interplay of individual, community, and societal factors. By emphasizing narrative change as a tool to address systemic health issues, Harper and his team shed light on the power of stories and perceptions in shaping public understanding and policy responses to ACEs and substance use. They write:

ā€œThe impact of relational organizing strategies on public health, social, and educational systems suggest that these strategies may bolster primary prevention efforts for ACEs and substance use. Community organizing may help highlight the concerns of communities most impacted by health inequities and increase attention on strategies, resources, or the need to directly address ACEs, substance use, and social determinants of health.ā€Ā 

Christopher R. Harper of the National Centers for Disease Control and Prevention led the study, which included Cheribeth Tan-Schriner, Jordan Royster, Karie L. Morgan, Vanessa Burnett, Sarah Treves-Kagan, Joivita Bradford, Leah Ettman, Oscar Espinosa, and Erin Marziale.

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