LaVerne D. Miller, Esq.

Remarks submitted by Laverne D. Miller, Esq., Director, HTH Peer Advocacy Center

My name is Laverne D. Miller. I am a program director, I am an attorney, I am a mother, I am an African American and I am a survivor.

Trauma is often a central issue for people suffering from mental illness, substance abuse, co-occurring disorders. Funding must be directed toward developing integrated trauma, mental health and substance abuse services in our communities. (Jennings, Ann PhD. The Damaging Consequences of Violence and Trauma, 2004)

The failure of human services systems to develop strategies to integrate trauma informed services in all systems of care results in missed opportunities for healing and recovery. Systems that fail to meaningfully address the impact of violence, neglect, physical abuse and sexual abuse and other traumas are systems that are doomed to be ineffective.

Trauma is a National Issue Requiring a National response

• As many as 80% of men and women in psychiatric hospitals have experienced physical or sexual abuse

• Up to two-thirds of both men and women in substance abuse treatment report childhood abuse or neglect at the hands of a parent

• 80% of women in jail and prison have been victims of sexual and physical abuse

• Nearly 90% of women suffering from alcoholism were sexually abused as children or suffered severe violence

• Boys who experience or witness violence are 1,000 times more likely to commit violence than those who do not

Culturally Informed and Competent Trauma Services are Critical to an Individual's Recovery Process. Katrina has presented valuable lessons for all communities and stakeholders. Education of providers and the integration, enhancement and full utilization of existing community based resources create unique opportunities for recovery and rebirth.

• Although many people have resources and can be resilient in the face of a natural or man-made disaster, people who already are poor, marginalized and lack access quality mental health services may be at especially high risk for post-event psychological disorders like depression and post traumatic stress disorder

• Poverty Exacerbates Impact of Natural Disasters on Individuals and Communities

• The APA defines culturally competent skills as knowledge and skills to work within a community's history, psychological stressors, language, communication styles, tradition, values, help-seeking behaviors, informal helping supports and natural healing processes

• Culture makes a difference in what we see as traumatic and how we interpret the meaning of a traumatic event

• Culture influences how individuals and communities express traumatic reactions

• Culture is a context through which traumatized individuals or communities view and judge their own responses

• Culture defines health pathways to healing (Boyd, Beth Ph.D. "Trauma and Healing in Cultural Context: Issues from the Hurricane Katrina Disaster Mental Health Response")

After the Crisis: A Blue Print for Peer-provided Culturally Competent and Trauma Informed Services

• Peers were essential in providing services in the last three national disasters. The Oklahoma bombing, the World Trade Center Disaster and responding to the needs of south east Asians affected by hurricanes Katrina and Rita

• Collaboration of National Organizations and SAMHSA to address over the lack of integration trauma informed and peer- run and driven crisis services

• Goals are to educate communities and stakeholders about the efficacy of peer support services and assist communities in developing skills needed to be active partners in disaster relief activities and services

• Promote the inclusion of peers in disaster relief planning

• Promote the use of peers by relief agencies

• Promote funding of these services

Effective disaster planning and responses provide opportunities for inclusion and collaboration that can drastically reduce the stigma that prevents most Americans from accessing mental health services. It also has the power transform the overall quality of services for all of us. It helps us all move forward on the roadmap so clearly articulated in the New Freedom Commission Report.