Julie Morgan MS, Deputy Minister for Health and Social Services
Today I am publishing our review of the Welsh Government’s policy on Adverse Childhood Experiences (ACEs). I requested the review to see the progress made in delivering the policy and how it was contributing towards this government’s goal of ensuring all children in Wales have the best start in life and the opportunity to achieve their potential. The report can be viewed at:https://gov.wales/review-adverse-childhood-experiences-ace-policy-report
The review considered both the evidence which supported and questioned the continuing need for a central Welsh Government ACEs policy. It also investigated the extent to which ACEs had become embedded across wider Welsh Government policy. It was important to me that our stakeholders should be given the opportunity to contribute their views on how the Welsh Government’s ACEs policy should be developed in the future, including the role of the ACE Support Hub.
The publication of Public Health Wales’ study into ACEs in Wales, in 2015, http://www2.nphs.wales.nhs.uk:8080/PRIDDocs.nsf/7c21215d6d0c613e80256f490030c05a/d488a3852491bc1d80257f370038919e/$FILE/ACE%20Report%20FINAL%20%28E%29.pdf presented a strong case for the need for action on ACEs. Its findings informed the Welsh Government’s decision to prioritise action to tackle ACEs during this Senedd term. The study showed ACEs were widespread in Wales. It highlighted how those who had experienced multiple ACEs faced a far greater risk of experiencing poorer physical and mental health and living shorter, unhappier, unhealthier and less economically active and productive lives. However, it also showed how ACEs were far from inevitable or deterministic, could be prevented, including action by the government and how those who had already experienced ACEs could benefit from support.
The report I am publishing today brings together the main findings and conclusions from the review. These include clear evidence which demonstrates the strong association between ACEs and poorer outcomes and widespread support for government action on ACEs. The review found action on ACEs had become well embedded in Welsh Government policy and how the development and implementation of our ACEs policy had influenced some areas of UK government policy. It found there was strong continuing support amongst stakeholders for the ACE Support Hub. However, it also identified opposition to the ACEs agenda for a variety of reasons, which will need to be considered further in the development of any future ACEs policy.
I am grateful to everyone who took part in the review. Its findings support the continuing need for there to be a clear and consistent Welsh Government policy on ACEs and for further development to reflect what we found from the review. It presents a strong argument for a shift in focus from raising awareness and understanding of ACEs, towards effective help, informed by an understanding of the effects of trauma, which makes a positive difference to the lives of children and their families. There was also a call from stakeholders for better join-up between services working to tackle childhood adversity.
Having considered the review’s findings, I have identified a set of principles which I would like to inform the development of our future ACEs policy and work to prevent ACEs. These are as follows:
- Adverse Childhood Experiences are not inevitable. Where possible, the focus of ACEs work should be on preventing childhood adversity from happening in the first place. However, we cannot ignore the need to provide sympathetic responses and trauma informed support to those who have already been impacted by ACEs or the importance of adopting a strengths based approach and building resilience.
- Our approach to raising awareness of childhood adversity should support parents and must avoid unintended consequences, like stigmatisation or increasing preventable statutory interventions. A narrow focus only on parental behaviours should also be avoided. Preventing adverse childhood experiences requires attention to the wider social and economic contexts of family life.
- We need to be careful in our use of the term ‘Adverse Childhood Experiences’ (ACEs), as well as the language we use to describe adversity, and be mindful of its impact. ACEs should never be viewed as being deterministic.
- The ‘ACE score’ should not be used with individuals to determine risk or whether or not to offer an intervention or the type of intervention which should be offered.
- Work on adverse childhood experiences should reflect that ACEs are more concentrated in deprived areas. It needs to recognise that poverty and multiple deprivation are causal factors in at least some of these adversities.
- We should recognise, support and promote the contribution that community-based, self-help and peer support approaches can make in preventing childhood adversity and mitigating its impact.
I have asked my officials to establish a task and finish group to take forward the findings of the review and bring forward proposals for the future development of the Welsh Government’s ACEs policy. I want the group to comprise external stakeholders and Welsh Government officials from a wide range of services and policy areas, with a shared interest in preventing childhood adversity and providing support for those who have experienced trauma. I would like the group’s work to be guided by the principles I have set out above.
The review has highlighted the complex and inter-related nature of ACEs childhood adversities. It was conducted during the Coronavirus pandemic which was often at the forefront of stakeholders’ minds as they thought about the Welsh Government’s future ACEs policy. Evidence had already begun to emerge about the immediate impact which COVID-19 was having, particularly on some of our more vulnerable individuals and communities. It is likely that COVID-19 will have a much longer impact too and serve to exacerbate the difficulties and challenges which many children faced before the onset of the pandemic. I would, therefore, look to the task and finish group to consider how the Welsh Government’s future ACEs policy can contribute to the COVID recovery plan. Time is an important factor and so I have asked for the group to complete its work and report back to Welsh Ministers over the summer.