Dr Cathy Kezelman Adults Surviving Child Abuse Interview
A new report commissioned by Adults Surviving Child Abuse (ASCA) and prepared by Pegasus Economics, released, showed that as a nation, Australia could save a minimum of $9.1 billion annually by addressing the impacts of unresolved childhood trauma and abuse in adults.
ASCA is the leading national organisation for the estimated five million Australian adult survivors of childhood trauma. With Prime Minister Tony Abbott actively seeking alternatives to the Federal Government's proposals for the Health Budget, ASCA presented these cost savings to the government as part of its pre-budget submission, in the report – The cost of unresolved childhood trauma and abuse in adults in Australia.
The report presented evidence-based solutions for the structural budget deficit for the 2015-16 Budget, scheduled for release mid-May 2015. It highlighted the main steps to reduce these costs, including investment in specialist and trauma-informed services, training of primary care and allied health practitioners and accreditation.
The report considered the weighted costs of four of the many trauma-related issues Australian adult survivors of childhood trauma face – alcohol abuse, anxiety/depression, obesity and suicide/attempted suicide. By conservative measures, the cost to the budget of not addressing these impacts totaled a minimum of $9.1 billion annually for childhood trauma overall; or for child abuse alone, the minimum cost came to $6.8 billion annually.
The report presented the conservative estimated per affected person cost, for each of the four key areas as:
Alcohol abuse: $4,983 per person, annually
Mental illness: $7,686 per person, annually
Obesity: $6,042 per person, annually
Suicide/attempted suicide: $5,281 per person, annually
President of ASCA, Dr Cathy Kezelman, said: 'The Commonwealth Government's latest inter-generational report showed the major future stress on government expenditures to be in health outlays. ASCA wishes to work with government in response to the call for policy proposals to reduce health expenditure and improve health outcomes. Our report with Pegasus Economics identifies an area in which substantive real cost savings can be made. The long-term solutions will deliver genuine health outcomes through active, early and comprehensive intervention."
In the report ASCA outlined the main steps to help address childhood trauma and abuse in adults, which included:
Active investment in specialist services including specialist helplines and online services, which provide support, counseling and resources to promote recovery.
More, better trained and accredited treating practitioners who identify and address the underlying childhood trauma and abuse, rather than solely focusing on the immediate health issues, such as depression and alcoholism.
Investing in the training of primary care practitioners. In strengthening primary health responses survivors can receive the right support, either directly or through targeted referrals, including specialist referral, ideally from an accredited practitioner. This would provide a convenient fail-safe pathway to treatment i.e. No wrong door
System, service and institutional improvements. Raising awareness around the possibility of unresolved childhood trauma and abuse. Financing broad-based implementation of trauma-informed practice responses across health and human services to help minimise the impact of trauma and the risk of re-traumatisation.
Dr Kezelman added: 'ASCA has already made a significant contribution to helping address childhood trauma and abuse in Australia through broad-based dissemination of ASCA's Practice Guidelines for Treatment of Complex Trauma and Trauma Informed Care and Service Delivery. Their national and international uptake has already made a significant impact on public health outcomes.
'However, in order to reduce the costs associated with childhood trauma and abuse, and start to address the budget deficit, all governments need to make the appropriate investments, supporting early active and comprehensive intervention and the reorientation of health care services towards addressing core underling issues and not just symptoms."
Help and support is available from the ASCA professional support line on 1300 657 380, 9am- 5pm Monday-Sunday.
Interview with Dr Cathy Kezelman
Question: What surprised you most about this report -The cost of unresolved childhood trauma and abuse in adults in Australia' released recently?
Dr Cathy Kezelman: To the wider community the substantial costs to the Australian economy of not providing childhood trauma and abuse survivors with adequate services may appear astounding, however as experts in the field of trauma-informed practice, they merely validate what we have long observed.
Childhood trauma and abuse affects one in four Australian adults, which means someone you know is living with these effects; Now is the time to be addressing this in terms of solutions – particularly at a time when government is looking for cost saving solutions to develop policies around the budget.
Question: Can you talk us through how addressing unresolved childhood trauma and abuse in adults would save Australian governments billions each year?
Dr Cathy Kezelman: Firstly it's about identifying the issues and then it's about solutions. The report has identified that through an evidence-based, long-term solution we can turn the issue around. This means active, timely, comprehensive interventions including the implementation of a range of treatments as well as organisational and workforce development responses to the public health challenge of trauma. This includes the delivery of accessible affordable specialist services including helplines, online support and resources, a primary care workforce, alert and responsive to trauma, accredited skilled health practitioners and trauma-informed organisations and institutions.
Question: How can we Australians help in addressing unresolved childhood trauma and abuse in adults?
Dr Cathy Kezelman: As individuals and members of the wider community we need to ensure survivors feel heard, validated and supported, with a message of hope towards recovery. Having open discussions about the effects of childhood trauma and abuse helps to break the long-standing stigma and taboo and encourages survivors to share their story without feeling judged or blamed. On average, according to the Royal Commission into Institutional Abuse's interim report, it takes a survivor 22 years to speak about their abuse – living with it in silence for so long is unhealthy and we, as a community, need to embrace survivors for their courage and resilience.
Question: Can you talk about the correlation between the four key health areas the report presented?
Dr Cathy Kezelman: Childhood trauma and abuse survivors frequently adopt harmful behaviours as a coping mechanism- such as alcohol abuse, drug abuse, eating disorders and overeating, smoking, self-harm suicide and gambling. This can lead to mental health issues, medical problems, social issues and economic problems to name a few. ASCA selected the four health outcomes of alcohol abuse, mental health issues, obesity and suicide/attempted suicide as those on which to model costs.
The outcome of these coping strategies and attendant adverse health impacts is not only very costly in a personal sense to the survivor and their family, but also impacts hugely on the country's economy.
Question: What is ASCA?
Dr Cathy Kezelman: ASCA is the leading national organisation supporting the estimated five million Australian adults who are survivors of childhood trauma, including abuse. ASCA provides hope, optimism and pathways to recovery for adults. We provide information, support and targeted referrals on the ASCA professional support line on 1300 657 380, 9am- 5pm Monday-Sunday. We also provide resources which include fact sheets and videos on our website www.asca.org.au, education, training and other services.
Question: How will ASCA work with the government to reduce the health expenditure?
Dr Cathy Kezelman: ASCA has been providing 1300 and online services as well as professional development training to help support a trauma-informed response to the needs of adult survivors for several years.
We will be collaborating with government, both Federal and State, to present our policy solutions to help address the structural budget deficit, to reduce health and welfare expenditure and improve tax revenue and health outcomes – exactly what the Abbott government is looking for.
Question: Can you talk about who ASCA helps?
Dr Cathy Kezelman: ASCA provides professional phone support, information, resources, tools, education, training and other services to help Australian adult survivors and their friends, families, partners and loved ones. We also educate and train professionals across diverse disciplines and fields as well as care givers working with survivors to enable them to provide better support, services and treatment.
ASCA has been instrumental in supporting the work of the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, including the training of key workers and practitioners.
ASCA continues to advocate for public health responses to childhood trauma and abuse, which includes complex trauma, complex trauma services and a national trauma informed policy and practice agenda.
Question: If we suspect a child or adult is being abused, how is best to deal with the situation?
Dr Cathy Kezelman: Contact the police, appropriate child protection bodies and seek professional help and support, if you believe a child is being abused. For adult survivors, call ASCA's 1300 professional support line on 1300 657 380 which is equally for friends and family members of survivors, health professionals as it is for survivors themselves.
Interview by Brooke Hunter