Associate feature: A compassionate Scotland needs everyone

Adversity in childhood and the ways in which it can shape development into adulthood, is no longer a ‘specialist’ interest area for practitioners and academics. In Scotland there is now widespread interest in adverse childhood experience (ACEs) that includes policymakers, organisations across different sectors and the public. This increased awareness is shining a light on the importance of preventing ACEs in the first place, as well as on taking action across our system to counter the effects that ACEs can have.

Through the Scottish ACEs Hub (a group of people who work in health, education, justice, academia and the voluntary sector) NHS Health Scotland is working to ensure national policies and services are responsive. The Hub has recently published a briefing – Adverse Childhood Experiences in Context – which sets out the ways in which various sectors, with action at different levels, can use the principles behind ACEs to inform their work.

For example, legislation can help create a more equal society and the conditions which support families to give children the best start in life. Scotland is making progress in this area, including through the Child Poverty (Scotland) Act 2017.

Policy and strategy are also important to address the inequalities in society that affect the world in which children live and grow up. For example, ‘Equally Safe – Scotland’s strategy to prevent and eradicate violence against women and girls’ – and ‘Rights, Respect, Recovery’ – Scotland’s alcohol and drug treatment strategy – recognise the potential impact on children where families are struggling with violence, and drug and alcohol use.

ACEs are also about relationships. So services need to take account of the fact that experiences of childhood adversity are different for each individual. It is important that services respond in a specific and person-centred way, so that the interaction itself aids healing as part of an intervention.

The Scottish Government has made a commitment to addressing ACEs in the Programme for Government in the coming year (2019/20). This seeks to drive progress on the areas for action set out last year with the public sector, third sector and communities. It builds on existing commitments to progressing children’s rights and the national approach to ‘Getting it Right For Every Child’.

And locally, community-led ACEs Hubs have been developing across Scotland. There really is a strong appetite to make a difference to public health. For that to happen, the infrastructure must be there to support the action – from decisions to policy, on to resources and practice.

A ‘whole-society’ response is fundamental to tackling childhood adversity, and the health and social outcomes associated with it. It is for health, it is for education, and it is for justice to all play a part. Communities and families can influence change too: they can take account of and learn from ACEs, to reduce blame on people who may have experienced early trauma and adversity, improve our own relationships and improve children’s experiences.

Learning from studies on childhood adversity can create real change in communities across Scotland, to enable fairer opportunities for more people now, and in the future.

Find out more about the public health approach to ACEs: contact Katy Hetherington, Organisation Lead for Childhood Adversity, NHS Health Scotland katy.hetherington@nhs.net

This piece was sponsored by NHS Health Scotland