Adverse childhood experiences increase risk of mental illness, but community support can offer protection

People who have experienced abuse, neglect and other adverse childhood experiences (ACEs) such as living with domestic violence during their childhood are at much greater risk of mental illness throughout life.

Findings from a new national study across Wales found adults who had suffered four or more types of ACE were almost 10 times more likely to have felt suicidal or self-harmed than those who had experienced none.

The study by Public Health Wales and Bangor University also found that some basic community measures help build resilience which can help protect individuals from developing the mental health problems that ACEs can cause.

Results show that the more ACEs people suffered the greater their risk of mental illness throughout life. Having ever had treatment for a mental illness increased from 23 per cent of those with no ACEs to 64 per cent of those with four or more. For ever having felt suicidal or self-harmed the rise was from 6 per cent to 39 per cent.

Developing resilience through access to a trusted adult in childhood, supportive friends and being engaged in community activities, such as sports, reduced the risks of developing mental illness, even in those who experienced high levels of ACEs.

Overall having supportive friends, opportunities for community participation, people to look up to and other sources of resilience in childhood more than halved current mental illness in adults with four or more ACEs from 29 per cent to 14 per cent, and ever having felt suicidal or self-harmed from 39 per cent to 17 per cent.

Participation in sports both as a child and adult was a further source of resilience to mental illness, with being in current treatment for mental illness reducing from 23 per cent in adults that did not regularly participate in sports to 12 per cent in those that did.

Professor Mark Bellis, Director of Policy, Research and International Development for Public Health Wales, and Honorary Lecturer at the College of Health & Behavioural Sciences said:

“Around one in eight adults in Wales experienced high levels of ACEs such as abuse, neglect and domestic violence in childhood. This study shows how such childhoods can affect the mental health of individuals throughout their lives.

“However, our results also suggest that communities providing opportunities to engage and develop skills, treating children fairly and offering good role models may help protect individuals from some of the harmful long-term impacts of abusive homes.

“For too many people in Wales, ACEs are still part of childhood and a burden that some carry with them throughout life.

“Public sector organisations across Wales are already working together to reduce the number of children who suffer ACEs. By also cooperating on how we build fair and supportive communities we can increase levels of resilience in children and adults and ensure those who suffered ACEs can avoid many of their health harming consequences.”

Lead author, Professor Karen Hughes, of the University's School of Healthcare Sciences said:

“ACEs increase risks of mental illness, and resilience resources reduce them. Sadly, people who suffer ACEs are often doubly affected as they typically have fewer sources of resilience available at home, and can have more difficulty accessing such resources in the community.

“Preventing ACEs is a critical part of improving mental health in Wales, but making sure vulnerable individuals who continue to be affected by ACEs can build resilience will also contribute to the prevention of mental illness.”

Huw Irranca-Davies, the Welsh Government Minister for Children and Social Care, said:

“The experiences we have in childhood, good and bad, are instrumental in determining our life outcomes. Providing a safe and nurturing environment is the best way to ensure a child will become a healthier and happier adult; and one who will be able to go on to achieve their potential.

“The evidence is very clear. Those who experience poor quality and stressful childhoods are more likely to have poor life outcomes; and the more ACEs encountered, the greater the threat posed.

“The Public Health Wales study clearly demonstrates the scale of the challenge. ACEs are a tangible threat to the health and wellbeing, social and economic prosperity of individuals, communities and the country as a whole. This is why we have made tackling ACEs a cross-government commitment. 

“The Welsh Government is unable to tackle ACEs alone. It is vitally important for those supporting children and families to become ACE aware. That’s why I’m pleased we have been able to support Cymru Well Wales to establish the ACE Support Hub, which will have an important role in helping individuals, communities and organisations become ACE informed in their work.”

Sarah Powell, Chief Executive of Sport Wales, said:

"This is more compelling evidence on the wider benefits of sport and physical recreation. We know that around half the Welsh population participate regularly in sport, bringing positive aspects to their lives that include better physical and mental health, as well as enhanced social opportunities, confidence and many other aspects that contribute to a healthy lifestyle.

"What we need to focus on now is breaking down the barriers to sport and physical recreation for those people that are not yet benefiting.  Once we start tackling those issues then we can start to unlock a really healthy future for Wales."

ACEs are traumatic experiences that occur before the age of 18.  These experiences range from verbal, mental and physical abuse, to being exposed to alcoholism, drug use and domestic violence at home.

The Welsh Adverse Childhood Experience (ACE) and Resilience Survey was undertaken to examine individual and community factors that may offer protection from the harmful impacts of ACEs on health, well-being and prosperity across the life course.

Other key findings from the study include:

  • The proportion of people with four or more ACEs reporting current mental illness fell from 37 per cent in those with low overall adult resilience levels to 13 per cent in those with high overall adult resilience levels
  • The proportion of people with four or more ACEs reporting current mental illness fell from 35 per cent in those who felt financially secure for no more than a month to 11 per cent in those who felt financially secure for at least five years

Resilience is described as the ability to overcome serious hardships such as those presented by ACEs.

Data were collected between March and June 2017 in face-to-face interviews with a Welsh sample of 2,005 18-69 year olds, and a boost sample of 492 residents in areas with higher levels of spoken Welsh language.

The new report was published at the launch of a new multi-agency Adverse Childhood Experience (ACE) Support Hub in Llandudno on 18 January.  The Hub will help organisations and communities across Wales to discover more about ACEs and their impacts, and to understand what action they can take to become more ACE informed.

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Publication date: 18 January 2018