Mark Atanasoff, Executive Director, Ontario Aboriginal HIV / AIDS Strategy (OAHAS)
Adverse Childhood Events And Trauma-Informed Care
Close relationships are critical to health. For children, those are relationships with parents, for adults the circle is wider—parents, partners, children and other loved ones. What happens in those relationships, the support and security that we provide for one another, and the stress and harm we do one another, are a powerful in?uence on the health of our bodies.
So I’m lucky enough. So I’m indigenous myself, and I’m lucky enough to work for OHAS. I just got hired back in July but my previous background is in child welfare, and so I have 12 years of experience working in the indigenous child welfare, plus working provincially at the Ontario Association of Childrens Aid Societies. So I was there at the early stages of ACEs, where we can make an impact and also now at OHAS at the late stages and so my experiences in child welfare, what I found out was that this system actually did wonderful things but it also caused harm, and it actually amplified the ACEs score. And so the agencies that I was lucky enough to work with, the ones where they identified that the system was causing harm, they changed the system and these tried to be more helpful.
So in one example an agency realized that they were only looking at short-term issues and they were doing apprehensions bringing children into care based on short-term risks but when they actually look at the totality and they looked at ACEs they realized that they were causing harm. And so where there was a structural issue with a family around caregiver capacity issues they actually made it really difficult to bring a child into care, and what they did is they applied resources to do admission prevention and they reduced their indigenous number of children in care from fifty to four Based on that approach. So they sort of reinvented their child welfare system but they took a lot of risks that I guess not all staff were comfortable with, and so they sort of changed the system by taking on more risk so risk so they didn’t bring the child into the system.
Their workers were basically saying you know you’re causing risk to the family, we need to bring these children into care, and these agencies decided no it’s better to keep the children in the community, provide resources to the families and so they they took the risk that the child was safer in the community. And so that’s what they did. Now another agency the way they reduce the number of children in care in terms of providing support, when they looked at the modeling, they had a child in their care that died through a suicide, and when they analyzed the case they realized that the child was getting access to all sorts of services in terms of psychological, and all the case management, and all the good stuff, and you know everybody was compliant and so the child was being seen and had a foster parent, but what was missing in the child’s life was a connection to family and community.
And so they analyzed that situation, and so this child was thriving in the professional world, and hit all the compliance metrics, but wasn’t thriving in the connection to family and culture, and community, and so what they did is they started a program called Forever Networks. And so what the program was about was that they took a whole bunch of children that were in care and what they did is some mobility mapping, and they sort of identified the child’s natural networks, natural protective networks of family and friends, and what they did is go through a program with a child, and they map out all the meaningful relationships in that child’s life, and what they do then is they do sort of like an intervention case conference and they bring in all these natural supports.
And what they do is they identify all the unmet needs of the child that the professional system really can’t meet, and so what happens at the end of this, you know sort of like this, it takes about eight meetings or eight sessions, and what they do is they identify that all these unmet needs can be addressed through their natural networks and not the professional networks, and what they found out that these natural networks or this love network. They can hit the unconditional support so it’s the ones that could be there at three o’clock in the morning, it’s once that can be there you know at any time, addressing some issues that the professional network can’t do, and so that drove down a lot of placement issues, it addressed a lot of unmet needs, and so they found that the child was thriving more through these natural networks and so that’s what they identified.
And what I missed on the story, sorry for rambling was that when the child did pass away, the one who did commit suicide they found that there was like a hundred family members that showed up to the funeral but none of these hundred family members were involved in the in the care planning for the child. And so that was the epiphany moment, and so the correlation to the HIV sector then is maybe the system isn’t causing harm to our members, but I think we’re ignoring the ACEs and so I think there’s a reliance on the professional network to solve everything around somebody who’s involved with HIV at risk or whether has HIV, and the issue then is at OHAS what we’re going to do is sort of bring this Forever Network concept to this sector.
And so we will do referrals to the professional network, but what’s missing because I know for myself being here if I didn’t get kindness or love I wouldn’t be here. So I’ve tapped into the professional market I’ve done counseling and all this other stuff. But without love, you know life is not enjoyable there’s no motivation, it just it’s a struggle. And so at OHAS what we’re gonna try to do is bring this Forever Network concept and work with their community so that they are going through this program that they’re integrated with their friends and family and their community. That should then probably have a positive effect on the professional network in terms of engagement in medical adherence and there should be like hopefully a correlation that we could see better outcomes in the professional network. But we know the professional network should be like a brief service. It’s not sustainable right now, and so there’s no resources going to this Forever Network concept. So that’s sort of what we want to do with OHAS. And I think that’s it. [Applause] [Music]