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Legacy of childhood trauma costs billions

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The diagnosis and treatment of adults suffering the effects of childhood trauma needs to be included in GP training and should be incorporated in mandatory national guidelines, according to a child abuse advocacy group.

The group Adults Surviving Child Abuse (ASCA) claims that billions of dollars of scarce health funds are being wasted, and many people are suffering unnecessarily, because of widespread ignorance among health practitioners about the lingering effects of childhood trauma and how to treat it.

Guidelines developed by the ASCA, The Practice Guidelines for the Treatment of Complex Trauma & Trauma Informed Care and Service Delivery, have been recognised as an Accepted Clinical Resource by the Royal Australian College of General Practitioners.

The recognition means the resource is considered a useful contribution to general practice, but is not produced to the standard required for it to be adopted as a clinical guideline.

The College advised practitioners that “a degree of clinical interpretation and caution is applied when using [an Accepted Clinical Resource] to guide practice. This is because the evidence base in support of the content is either limited or not clearly described”.

Nonetheless, ASCA President Dr Cathy Kezelman said the RACGP’s recognition was a significant step toward improving the treatment of people suffering the effects of childhood trauma.

“Unresolved trauma is one of our greatest public health concerns,” Dr Kezelman said. “Failures to identify, acknowledge and respond appropriately to trauma costs the public health system billions of dollars.”

Dr Kezelman said such trauma, which could include mental, physical and sexual abuse, as well as neglect and domestic violence, was the root cause of many significant mental and physical health problems, as well as substance abuse.

She said the guidelines had been developed over several years based on the best available evidence, and provided a sound basis for training and care.

“The guidelines offer the grounding for the education and training needed for all health professionals, including those in primary health care. Improved practices, as identified in the Guidelines, will help reduce the burden of disease related to unresolved trauma and improve the lives of victims, as well as those of their children,” Dr Kezelman said.

She cited evidence from studies overseas showing that patients whose prior trauma is identified and acknowledged made 35 per cent fewer visits to their doctor and had 11 per cent fewer episodes of emergency department care.

ASCA Advisory Board member and RACGP Fellow Dr Johanna Lynch said the significance and prevalence of adults who have survived childhood trauma was currently not acknowledge din general practice training, and GPs needed to become skilled in identifying, managing and caring for those who carry the legacy of such experiences.

Dr Kezelman said that in addition to developing such training, the Federal Government should also ensure ASCA guidelines were embedded as standards for practice in primary care.

Adrian Rollins