How the San Diego Foundation is helping nonprofits address and prevent child abuse and trauma

The findings from a state report on child abuse and its health impacts confirm what many nonprofit organizations and government agencies have already been working toward: developing and providing services to support the physical and emotional health and well-being of young children and their families.

In “Roadmap for Resilience: The California Surgeon General’s Report on Adverse Childhood Experiences, Toxic Stress, and Health,” experts outline the public health issues of toxic stress and abuse, along with solutions and recommendations for addressing these issues on a community level.

Recently, as part of its strategic plan to support resilient communities and foster equity, the San Diego Foundation (informed by the “Roadmap” report) awarded $252,000 in grants to nearly a dozen local nonprofit organizations working to prevent this kind of abuse while also providing services and care to address it.

“Supporting children and families who experience abuse or trauma and strengthening services that prevent trauma are important components of a healthy, thriving, resilient region,” Katie Rast, director of community impact at the San Diego Foundation, said in a statement. “This care is critical for children in the earliest stages of life. We’re thankful to these regional partners who will equitably serve San Diego families with sensitivity and care.”

Rast took some time to talk about some of the findings of the state report and some of the local work being done in partnership with organizations and agencies to address and repair the harm done by trauma experienced in childhood. (This interview has been edited for length and clarity. )

Q: What initially stood out to you in the “Roadmap for Resilience” report?

A: It’s a really important report, and it shared a lot of things that I found impactful and striking. I think a couple of things that stood out, in particular, are drawing this clear line between toxic stress and trauma, and negative health impacts. I think that’s an extremely important public health determination. That’s one side of the coin that we really need to address around trauma, toxic stress, and Adverse Childhood Experiences (ACEs). We know, definitively, that those things relate to negative health and social impacts. The other side of the coin that I think is equally important is that despite those challenges, there is hope. Just as these negative experiences can cause harm, we also know that positive, nurturing experiences can heal. I think those things are important to keep in mind, especially because it can be sad to think about the impact of something like an adverse childhood experience, but it’s been shown that children are so resilient and are able to heal from trauma through nurturing, positive experiences.

Q: What was the San Diego Foundation’s criteria for deciding which organizations would receive these grants?

A: Each of these organizations is doing really important work and, of course, they’re part of a larger ecosystem of many organizations doing great work in the community. The groups that received these grants, they’re providing a wide range of services: from supporting some of our youngest children currently in foster care and having a child-centered approach to working with parents with a whole-family approach, to thinking about how to both support the child and support the parent/caretaker.

Both generations benefit when considering what it looks like to provide support for the whole family. We asked organizations to apply these two criteria to abuse prevention, mental/behavioral health support, early intervention, and health equity as the things that they were able to speak to and acknowledge that they are committed to in their work. All of these organizations (that received grants) were able to represent their work in a way that really centered children, families, health equity and those other preventative measures.

Q: Why the focus on young children up to age 5? As opposed to addressing these issues in children up through 18 years old?

A: Yeah, good question. Through our Early Childhood Initiative, we’re really focused on the idea of fostering equitable opportunities for young children and families. Our work has really been guided by research and data that shows that those earliest developmental years of 0 to 5 — and that includes prenatal development — are so important for parents and kids.

When we think about the potential to make an impact in a lifetime trajectory for an individual, there are critical developmental processes that happen during those years of life that really help set an individual up for a strong start for the rest of their lifetime. Much of what’s guiding our work in the Early Childhood Initiative is really focused on the unique, important developmental period that occurs during ages 0 to 5, and how it impacts the rest of someone’s life.

We are also considering this two-fold benefit of what happens when you support parents. Often, in this particular initiative, we’re thinking about parents and caretakers of young children, and the two-fold benefit of both supporting those parents now and strengthening this future generation who will be the next generation of parents.

Even though that relates specifically to things like abuse prevention and support for children and parents who have experienced trauma, we also recognize that, in San Diego County, children 5 and younger make up the largest group of referrals to child welfare services. So, there’s also a really important intersection between support for young children and families, and some of the challenges that a lot of these children have seen already, so early in their lives. It’s another one of those heart-breaking facts, but it’s an important fact. We’ve seen, through a lot of great research, that those young kids are so incredibly resilient if they’re able to receive support services and be in a nurturing, caring environment, they will go on to lead healthy and happy lives.

Q: What kinds of health and social impacts do these Adverse Childhood Experiences (ACEs) have on children and families?

A: So, going back to the Surgeon General’s report, which is loaded with amazing data, a couple of things that I think are really important from that report are that there’s an association between an adverse childhood experience and an increased risk for some leading causes of death, including things like heart disease, respiratory disease and even suicide. Similarly, social outcomes have a similar correlation, in that folks who have adverse childhood experiences early in their lives are statistically more likely later on in life to not graduate from high school, experience higher unemployment, or experience homelessness.

Q: What kinds of immediate steps are the selected nonprofits implementing that address and prevent the Adverse Childhood Experiences (ACEs) outlined in the “Roadmap” report?

A: Some of them are going to be working directly with providers who are in constant contact with young children. We know that, so often, teachers, childcare providers, doctors and other service providers come into contact with these young children, and they need to be trauma informed. It’s important that they are able to not only recognize and understand trauma when they see it, so they can respond to it appropriately, but also respond to parents in a way that is perhaps quicker to move to a supportive action, rather than a punitive one. That would mean asking questions like, “How are you doing?” or “Is there something I can do for you?” Trauma-informed care training is really important, and we see examples of our nonprofit partners doing exactly that type of work, to ensure that all adults who come into contact with kids and their parents/caretakers have that understanding. We also have organizations that are working as community-based, trusted messengers who are ensuring that service is provided in a way that is culturally competent, linguistically appropriate, and delivered through community-based networks that are seen as trusted advisers, peers, and friends. That’s a growing network that’s being developed.

Q: And what kinds of systems-level changes are being made, or planning to be made, that address and prevent these experiences (ACEs)?

A: We’re at the beginning of our journey with our new strategic plan, but it’s focused on building resilient communities. That is working to center equity when we consider our work in the community, so moving forward, we’re grateful to have the partners that we do because we recognize that they provide such important information and knowledge of the work that’s happening in our community. We know that it takes partners, making sure that prevention is a significant component of the work that we’re doing, and that includes support for families that includes early intervention and recognizing that this work has to be cross-sector in nature with government, nonprofits, and other community stakeholders all coming together. That’s a truly inclusive process and the design of that care is informed by the community and by those who might participate in the services.

In thinking about systems-level change, also thinking about systems-level design is critical. Coming from a human-centered design background, I think there’s a great intersection that’s taking place where when we think about service delivery, and we look at how services are rolled out in our community, if we start by considering that system through a human-centered design approach, that means we should always be sure that the individuals we aim to serve are actually informing this design. It’s important not only that there’s a feedback loop and that the services and the systems are being informed by the community, but also that the providers of the service are delivering it in a way that feels based in trust, that feels appropriate, and that feels supportive to those who might interact with the service.

Q: Why does this matter? What kind of difference does it make to have these immediate and systems-level changes be informed by the people and communities who will be receiving these services?

A: Particularly when we think about families and providing services to parents that are focused on children, when we’re hoping to address really delicate, challenging issues like trauma, that is the optimal place for us to start from. That the way those services are delivered, and the way that the systems that deliver those services are designed, are predicated upon the needs and the input of the individuals who might be the end-users of those services. It’s akin to “nothing about me, without me,” which is ensuring that if I’m someone who’s going to access a service, I should feel that that service was genuinely designed in a way that had me in mind and left me feeling good, or at least positive.

Q: How does the foundation’s Early Childhood Initiative fit into this work with the selected nonprofit organizations that received these grants? What’s the initiative’s vision for its own work and examples of ways that this vision is being realized?

A: The Early Childhood Initiative, which is a relatively new initiative launched in 2018, is part of the grant-making that happens annually through this initiative. This is really our second cycle of grant-making. For us, this is yet another opportunity to connect with important partners and nonprofits who are doing this work on the ground, and also to consider how we connect this some of our other work. In the last year and a half, a lot has happened. In addition to being able to work through this initiative, we’ve also had the opportunity to work with a lot of education/early education and care providers, and the County of San Diego Health and Human Services agency through our San Diego COVID-19 Community Response Fund. We’re weaving all of that together so that, in the coming year, we’re considering things like access to affordable, quality care, which is an important tenet of our early childhood work.

We’re also overlaying that work with this commitment to ACEs prevention and trauma-informed care because we see that they go hand-in-hand. We want to be sure that parents can access affordable, high-quality care for their children; in order for those children to have the greatest opportunity for a strong and healthy start, we also want to be sure that they are in a supportive, nurturing environment and exposed to positive experiences through their network of care. Another interesting piece of that is related to our desire to recognize just how important the issue of childcare is, and to continue working with our partners to elevate that issue and continue building a narrative with our partners around the connection between the local workforce and economy, and the role that health care plays. So, we’re continuing to roll out work that is going to look at a post-COVID picture of how parents are faring, the needs that they have around childcare, and how that relates to our ability to build a strong, resilient San Diego.