Mental Health Care That Disrupts Cycles of Violence | Celina de Sola | TED

Summary

The speaker addresses the staggering homicide rates in Latin America, particularly in the Northern Triangle, and the profound impact of violence on mental health. They highlight the vicious cycle of violence leading to more violence and the lack of mental health care in affected communities. The solution proposed involves training existing government employees in trauma education and self-care, creating a network of lay mental health workers to combat the cycle of violence and promote community resilience.

Takeaways

• 📊 Latin America, despite having only 8% of the world's population, experiences one third of global homicides, with the Northern Triangle countries being particularly affected.
• 💔 The impact of violence on individuals can be severe, leading to trauma that impairs critical thinking, emotional regulation, and can increase health risks.
• 🔄 Exposure to violence can perpetuate a cycle of violence, with survivors being significantly more likely to be involved in further violent incidents.
• 🌐 The speaker emphasizes the importance of mental health care in breaking the cycle of violence, but highlights the lack of access to such care in affected communities.
• 🇺🇸 In the United States, there are 270 mental health care workers per 100,000 people, compared to just two in Honduras, illustrating the disparity in mental health resources.
• 🛠 The speaker suggests re-envisioning resources and mentions that there are ways to improve mental health access in communities, which are already being implemented.
• 🏥 Glasswing International is training government employees in trauma education and self-care, aiming to create a network of lay mental health workers.
• 🏫 In schools, the presence of a caring adult can significantly improve children's grades, conduct, and resilience, which is part of the strategy to address trauma.
• 👮‍♂️ Police officers trained in trauma-informed practices reported better emotional regulation and felt more equipped to support their peers.
• 🎓 The story of Walter, a young man trained as a school coordinator, illustrates the transformative power of education and mentorship in preventing retaliatory violence.
• 🔄 The speaker calls for a systemic approach to training in public institutions to create a network of trauma-informed services that can be scaled and sustained.

Q & A

What is the shocking statistic about Latin America's homicide rate in relation to its population size?

Latin America is home to only 8% of the world's population but accounts for one third of its homicides.

Which region is referred to as the Northern Triangle, and why is it mentioned in the script?

The Northern Triangle refers to Honduras, Guatemala, and El Salvador, and it is mentioned because these countries experience extreme levels of violence and its impact on health and well-being.

How does exposure to violence affect a person's brain and its core functions?

Exposure to violence can result in trauma, which causes the brain's stress response to shut down core functions like problem-solving, critical thinking, and emotional regulation, while elevating those needed for protection and survival.

What are some of the health risks associated with exposure to violence?

Health risks associated with exposure to violence include increased risks of lung and heart disease, diabetes, anxiety, and depression.

How can exposure to violence potentially lead to a cycle of more violence?

Survivors of violence are up to six times more likely to be involved in violence or be revictimized, creating a vicious cycle.

What is the key solution proposed in the script to interrupt the cycle of violence?

The key solution proposed is addressing the underlying trauma with better access to mental health care.

Why is access to mental health care in the Northern Triangle countries a significant issue?

Access to mental health care is a significant issue because it is virtually non-existent, with a stark contrast in the number of mental health care workers per 100,000 people compared to the United States.

What is the approach taken by Glasswing to improve mental health care access in these communities?

Glasswing trains existing government employees like teachers, nurses, doctors, and police officers in trauma education and self-care, creating a core of lay mental health workers who can buffer the impacts of violence and trauma.

How has the training of health care workers by Glasswing impacted their ability to recognize and respond to trauma?

The training has enabled health care workers to recognize the signs of trauma, help patients understand their experiences, and equip them with coping tools or refer them for further help, reducing the likelihood of revictimization by up to 30 percent.

What is the story of Walter and how does it illustrate the impact of the program run by Glasswing?

Walter, a 17-year-old student from a high-crime community, was trained and became a school coordinator leading a glee club. When faced with the violent death of his sister, the influence of his mentor and the responsibility towards the children he worked with helped him resist the urge to retaliate violently, illustrating the program's success in breaking the cycle of violence.

What is the broader strategy proposed by the speaker to infiltrate the space between violent stimulus and response?

The strategy involves training everyone in public schools, hospitals, clinics, and police precincts on trauma, education, and self-care, followed by training subsets as interventionists and trainers to create a growing network of trauma-informed services in each community.

How does the speaker describe the power of community in the context of healing and resilience?

The speaker emphasizes that violence happens between people, but so does healing. The power lies in people, relationships, and a community's ability to heal itself, highlighting the importance of community and systems change.

Outlines

00:00

😱 The Impact of Violence on Mental Health in Latin America

This paragraph highlights the startling statistic that Latin America, despite having only 8% of the world's population, accounts for one-third of global homicides, particularly in the Northern Triangle countries. The speaker, hailing from this region, emphasizes the profound effects of violence on mental health, productivity, and well-being. Exposure to violence can cause trauma, leading to a shutdown of critical cognitive functions and an increase in survival instincts. This not only hampers learning and decision-making but also raises the risk of physical and mental health issues. The speaker illustrates the collective impact on communities and the potential for individual and collective trauma to escalate. Moreover, the cycle of violence is perpetuated as survivors are more likely to be revictimized or involved in further violence. The paragraph concludes with a glimmer of hope, suggesting that addressing trauma through improved mental health care can break this cycle, but acknowledges the dire lack of such resources in affected areas.

05:00

🛡️ Breaking the Cycle of Violence with Community Empowerment

The second paragraph delves into the innovative approach of Glasswing, an organization that trains government employees such as teachers, nurses, doctors, and police officers in trauma education and self-care. This initiative aims to create a network of lay mental health workers who can mitigate the effects of violence and trauma on themselves and their communities. The speaker shares the success of this program, which has reduced the likelihood of revictimization in hospitals by 30% and improved academic and behavioral outcomes in schools. The empowerment of police officers through training has also enhanced their emotional regulation and capacity to support peers. A poignant story about Walter, a 17-year-old from a high-crime community, illustrates the power of this approach. After his sister was murdered, Walter, who had been trained as a school coordinator, chose not to retaliate with violence, thus breaking the cycle. The speaker advocates for systemic change through community empowerment and the training of individuals to provide mental health care within their communities, emphasizing the scalability and cost-effectiveness of this model.

Keywords

💡Homicide

Homicide refers to the act of one human killing another. In the context of the video, it is highlighted that Latin America, despite having only 8% of the world's population, accounts for one third of the global homicides, indicating a severe issue of violence in the region.

💡Northern Triangle

The Northern Triangle is a term used to describe the countries of Honduras, Guatemala, and El Salvador in Central America. The video script emphasizes the extreme levels of violence in these countries, which significantly contribute to the high homicide rates mentioned.

💡Trauma

Trauma is defined as a deeply distressing or disturbing experience that can lead to long-lasting mental or emotional effects. The video discusses how exposure to violence can result in trauma, affecting an individual's brain function and ability to engage in normal activities such as problem-solving and emotional regulation.

💡Stress Response

The stress response is the body's reaction to stress, which can include physical, emotional, and behavioral changes. The script explains how trauma can trigger the brain's stress response, impairing core functions and enhancing survival instincts, which can complicate learning, decision-making, and relationship maintenance.

💡Mental Health Care

Mental health care refers to the treatment and care provided to individuals with mental health disorders or emotional distress. The video argues that addressing the underlying trauma through better access to mental health care can interrupt the cycle of violence, but access to such care is virtually non-existent in the Northern Triangle countries.

💡Vicious Cycle

A vicious cycle is a series of events where each event amplifies the next, leading to increasingly negative outcomes. The script uses this term to describe the perpetuation of violence, where survivors of violence are more likely to be involved in further violence, creating a cycle that is hard to break.

💡Trauma-Informed Care

Trauma-informed care is an approach to treatment that recognizes the presence of trauma symptoms and acknowledges the role trauma may play in an individual's current problems. The video outlines how training healthcare workers in trauma-informed care can reduce the likelihood of revictimization and improve patient outcomes.

💡Resilience

Resilience is the capacity to recover quickly from difficulties or to withstand hardships. The script discusses the importance of building resilience in communities affected by violence, emphasizing the role of mental health knowledge and skills in helping communities heal and become more resilient.

💡Glasswing

Glasswing is an organization mentioned in the script that is working to address the issue of violence and trauma in the Northern Triangle countries. They train government employees in trauma education and self-care, aiming to create a network of lay mental health workers who can provide support within their communities.

💡Community Healing

Community healing refers to the process by which a community collectively addresses and recovers from trauma or violence. The video emphasizes the importance of community healing in breaking the cycle of violence, suggesting that empowering individuals within the community to provide mental health support can foster this healing process.

💡Viktor Frankl

Viktor Frankl is a renowned psychiatrist and author of 'Man's Search for Meaning,' from which a quote is referenced in the script. His work emphasizes the importance of finding meaning in life's experiences, even in the face of suffering. The video uses his quote to illustrate the power of choice in responding to traumatic events and the potential for growth and freedom in those responses.

Highlights

Latin America accounts for only 8% of the world's population but experiences one third of its homicides.

Northern Triangle countries of Honduras, Guatemala, and El Salvador are particularly affected by high levels of violence.

Violence exposure can lead to trauma, impairing critical thinking, problem-solving, and emotional regulation.

Trauma can increase the risk of physical and mental health issues, including heart disease, diabetes, anxiety, and depression.

Survivors of violence are up to six times more likely to be involved in further violence or revictimization.

Mental health care access is crucial to interrupt the cycle of violence but is nearly non-existent in affected communities.

In the U.S., there are 270 mental health workers per 100,000 people, compared to only two in Honduras.

Glasswing International is training government employees in trauma education and self-care to create a network of lay mental health workers.

Health care workers are being trained to recognize trauma signs and provide coping tools or referrals.

Trauma-informed care in hospitals can reduce the likelihood of revictimization by up to 30 percent.

Access to caring adults in schools improves children's grades, conduct, and resilience.

Police trained in trauma-informed methods reported better emotional regulation and felt equipped to help their peers.

The story of Walter, a 17-year-old who chose not to retaliate after his sister was killed, demonstrates the impact of trauma-informed intervention.

Glasswing's approach focuses on training individuals within the community to provide mental health support and prevent the cycle of violence.

The model is scalable and cost-effective, utilizing existing public systems and personnel.

The power to interrupt violence lies in community healing, relationships, and individuals' responses to trauma.

Viktor Frankl's quote emphasizes the power of choice in response to stimuli, which can lead to growth and freedom.

The goal is to infiltrate the space between violent stimulus and response with mental health knowledge and skills.

Transcripts

There's a shocking statistic I want to share with you.

Latin America is home to only eight percent of the world’s population

but one third of its homicides.

This is especially extreme in the Northern Triangle countries

of Honduras, Guatemala and El Salvador,

where I'm from and where I live.

Just imagine the impact that this kind of unrelenting violence can have

on a person's health, productivity and well-being.

Especially because we know that if we're exposed to violence,

this can result in trauma.

And when that happens,

our brain's stress response actually shuts down core functions

like problem solving, critical thinking and emotional regulation.

And it elevates the ones that we need to protect ourselves and survive.

So this makes it really hard to learn to make decisions

and even maintain relationships.

It can also increase our risks of lung and heart disease, diabetes,

anxiety and depression.

So imagine what this can mean for entire communities

when almost everybody can be walking around

with unaddressed stress and trauma.

Then picture what can happen as individual

and collective trauma collide.

To make matters worse,

we know that exposure to violence can lead to more violence.

Research has shown that survivors of violence

can be up to six times more likely

to either be involved in violence or be revictimized.

It's literally the definition of a vicious cycle.

The good news is we know that we can interrupt this cycle

by addressing the underlying trauma with better access to mental health care.

The only problem is

access to mental health care in these communities

is virtually non-existent.

So just to give you an idea,

in the United States,

there are about 270 mental health care workers

for every 100,000 people.

In Honduras, this drops to two.

So we're left with this classic conundrum.

We know how to help solve the problem,

but we don't have the resources to do it.

But what if we re-envision what or who these resources could be?

I think we should,

because there are ways to flood communities

with access to mental health care.

It’s already being done, and it’s working.

And I want to tell you a little bit about how we're doing it at Glasswing.

We're training thousands of existing government employees like teachers,

nurses, doctors and police officers

on trauma education and self-care.

We're essentially trying to create a whole core of lay mental health workers

who are already serving on the front lines

and can therefore step in and buffer the impacts of violence and trauma

on themselves and on the communities they serve.

We've trained health care workers

to be able to recognize the signs of trauma,

to be able to help patients understand what they're experiencing

and equip them with tools to cope or refer them if they need it.

We've actually seen that trauma-informed violence prevention work in hospitals

can reduce the likelihood of revictimization by up to 30 percent.

(Applause)

In schools, we know that if children and adolescents

have access to a caring adult that can help them cope with stress,

their grades improve,

their conduct improves and their resilience.

And in our work with police,

90 percent of the police we trained

actually felt better able to regulate their emotions

and to deal with anxiety and fear.

Eighty percent even told us

that they felt better equipped to help their peers.

I want to share a story with you.

Back in 2018, our Guatemala team was working in a community

with really high rates of crime, violence and stigma.

One of the schools we were working in

is actually a school where kids ended up

if they got expelled or if they got in trouble.

So that's why Walter, a 17-year-old student,

was really surprised and a little confused, when Eluvia,

one of our trauma-informed school coordinators,

showed up to recruit him and his friends to work at the local primary school.

But Eluvia's from that community,

and she knew that if she could empower a young man like Walter

to become involved and become a school coordinator,

she could not only transform his life

but also the life of the kids he'd work with.

So sure enough, a couple of weeks later,

Walter was trained and leading a group of 20 little kids in a glee club.

He loved it.

(Applause)

He loved it so much that he continued to show up every week

for over two years.

But one afternoon,

one of Walter's neighbors ran into the school screaming

that Walter had to get home

because his sister had been shot and killed.

Walter sprinted out.

And as he described it to me,

he felt his mind and body go numb.

Then he felt his heart start to race and his chest fill with rage.

He knew who had killed his sister.

And he ran up to his room to get a gun.

Let me pause there for a sec.

Do you remember what I told you a minute ago,

about how violence can lead to more violence?

That could have been Walter.

But it wasn't.

Because he told me that when he pictured his mentor, Eluvia,

and the little glee club kids finding out that their role model had killed someone,

he put the gun down.

And that, that right there --

(Applause)

is where the cycle of violence stopped.

(Applause)

That's everything.

I have other stories like Walter and Eluvia's.

But to interrupt and to stop this epidemic of violence,

we need thousands more.

And there are great ways to do this that are replicable.

We know that we can provide more health care in communities

provided by regular people.

I’m talking about community, and I’m talking about systems change

at the same time.

First, we train everybody in public schools,

public hospitals, clinics and police precincts

on trauma, education and self care

so they can better take care of themselves

and also those that they serve understand trauma and manage it.

Then we train a subset as interventionists

so they can deal with emergencies,

providing crisis intervention and ongoing support.

And then we train a subset of those interventionists as trainers

so they can continue to train their peers

and they can train other organizations

so we can have a growing network of trauma-informed services

in each community.

The great thing is this model is scalable and it’s cost-effective,

because we're working within public systems

with people that are already there.

So really, we know that violence happens between people,

but so does healing.

That's where it starts.

So we know the power lies in people, in relationships,

in a community healing itself.

One of my favorite quotes by Viktor Frankl in “Man’s Search for Meaning” is:

"Between stimulus and response, there is a space.

In that space is our power to choose our response.

And in our response lies our growth and our freedom."

Our goal is to literally infiltrate the space

in between violent stimulus and response,

with mental health knowledge and skills

so that communities can pave their own way to healing and resilience.

Thank you so much.

(Applause and cheers)