“An Entire Nation Traumatized”
By Madhuri Jha, LCSW, MPH (she/hers), Director of the Kennedy-Satcher Center for Mental Health Equity
In between meetings and planning for the inaugural Mental Health Equity Speaker Symposium, I admit that I have found myself distracted at times in the past couple of weeks, unable to ignore the images of children and families trying to escape Afghanistan. The United States Government announced it was ending its 20 year occupation of the country, and the world watched in horror as the Taliban took over the Afghani government. Men dropping to their deaths from ascending planes, and babies being handed to US soldiers over wire fences. I recall my experiences working with refugee families and children, many who told me their own stories of making the tumultuous journey across the US border in hopes for a safer life. Their faces are imprinted in my memory, as they pursued treatment with me for Acute or Posttraumatic Stress Disorder (PTSD). As I sat down to write this month’s blog, I realized that the levels of trauma depicted so regularly in the news are not only record-breaking, but their vicarious effects on us as a society are widespread and complex.
The diagnostic criteria for PTSD requires exposure to a traumatic event that is either direct OR indirect. Historically, PTSD diagnoses have been most commonly given to military veterans, survivors of violence or natural disaster, recently diagnosed medical patients, and people of color. Shaken by isolation and limited travel due to the COVID-19 pandemic, Americans have been forced to view repeated images of violence, distress and disaster in the news, in our efforts to remain informed about how the rest of the world is faring compared to us. An attempt to summarize just how much trauma the United States has endured over the last year is breathtaking.
The obvious trauma is national witness to the 637,000 deaths (and counting) due to COVID-19. In the midst of this, the US also saw the largest surge in gun violence recorded since 1960, with nearly 20,000 gun violence deaths and an additional 24,000 gun-related deaths due to suicide in 2020. Hate crimes have been steadily increasing since 2014, and the FBI recently reported twice as many hate-related incidents in 2019 than the year prior. While 2020 reports show a 7% decrease in hate crimes overall, there was a 150% increase in violence against Americans of Asian-descent. The televised trial for George Floyd’s murder included a graphic replay of the video of his death, as the trend of fatal police shooting is rising. 523 civilians were shot by police in the first six months of 2021, 104 of whom were black. Child abuse and domestic violence hotline calls surged at an alarming rate in 2020, likely due to heightened family distress during lockdown. And then there is the climate-related trauma. Climate scientists unanimously agree that 2020 was record-breaking for the U.S. with regard to the number of named tropical storms, wildfires, rain and flooding events, and episodes of extreme heat – 22 natural disasters amassing over 95 billion US dollars spent on damages. The month’s #KSCMHEPulse could be solely devoted to listing how many traumatic incidents qualify an American to receive a trauma-related disorder diagnosis due to direct or indirect exposure.
Lately, my discussions with other thought leaders bring us to a difficult dilemma with the overwhelming burden that trauma currently has on our society and what we can truly do to rectify it. Over the years, the healthcare system has grown increasingly comfortable with implementing trauma-informed approaches for high-risk and vulnerable populations. But revisiting the realities outlined in the above paragraph, we are now at risk of failing to meet trauma-informed treatment standards for our entire country’s population. The other truth about the above realities is that they have costed the United States billions of dollars in damage and recovery needs. If it is known that trauma-informed psychotherapy benefits the economy, then it could be said that the implementation of wrap-around trauma-informed services could only multiply that benefit. If mental health equity is health equity, then trauma-informed care can no longer be seen as a purely a psychological intervention. One of the easiest things we can reframe to alleviate this burden is to acknowledge that the communities we currently live in are all traumatized. Efforts should be geared towards applying a trauma-informed policy lens to all areas that Americans interface with, such as medicine, education, criminal justice, and employment. Often in therapy, the most powerful first step towards progress is when a clinician can tell a trauma survivor, “I believe you.” Imagine the impact we could have if we told whole communities, “We believe you.” To me, that’s a powerful first step towards sustainable, systemic recovery for an entire nation that is traumatized.
About the author/for immediate inquiry: Madhuri Jha, LCSW, MPH is the Director of the Kennedy-Satcher Center for Mental Health Equity – an entity of the Satcher Health Leadership Institute at the Morehouse School of Medicine. She has over a decade of service devoted to being a clinical practitioner, consultant, and leader in the public mental health and health equity fields. For immediate inquiries about the author or the work being done at KSCMHE, contact Mahia Valle, MBA at firstname.lastname@example.org