Addressing Adverse Childhood Experiences in Families Experiencing Homelessness

By Pooja Bhalla, DNP, RN, Illumination Foundation CEO

Clear links have been established between Adverse Childhood Experiences (ACEs), homelessness, poor health, and poor behavioral health outcomes. At Illumination Foundation, we clearly see the effects of unaddressed trauma playing out on children and adults experiencing homelessness.

ACEs research has demonstrated that multiple traumatic incidents in childhood are a predictor for risky health behaviors, chronic health conditions, low life potential, and early death. In 2015, after witnessing several incidents of children expressing suicidal ideation, Illumination Foundations children’s programming staff conducted a wide-ranging survey to understand the root causes of the children’s distress. We discovered that participating children had experienced an average of seven traumatic incidents each. To put this number in context, with an ACEs score of 4 or more, the likelihood of chronic pulmonary lung disease increases 390%, depression 460%, and attempted suicide 1,220%. There is also a high correlation between ACEs and homelessness as adults.

The high level of trauma witnessed by children experiencing homelessness mirrors the trauma many of their parents have experienced in their own lives. Parents who are themselves traumatized may not recognize or be able to cope with the health and mental health needs of their children—particularly those that require navigation through complex and unfriendly bureaucracies. We see this intergenerational cycle playing out in Illumination Foundation’s family emergency shelter settings. By embedding trauma-informed support services in the shelters, we are able to make a high impact in a short period of time.

When families enter our program, the children are immediately screened for trauma and developmental concerns. Through our many partnerships, we connect the children with one-on-one counseling, speech and language services, referrals for developmental and/or behavioral treatment, and in our newest partnership with CHOC, referrals to a primary care physician. Our staff also works with the children to develop art and science projects, read, complete homework, and play games. 

Adults are offered evidence-based parenting sessions to support the healthy development of their children, one-on-one counseling, substance use counseling, family systems counseling, and assistance navigating the health care system on behalf of their child. Additionally, each family is assigned a housing navigator, who conducts a housing assessment, identifying the family’s preferences and barriers, and develops an individualized housing support plan that includes short- and long-term goals.

Illumination Foundation’s integrated model of healthcare and housing is proving successful in addressing ACEs, promoting the healthy development of children, increasing family stability, and finding families homes. Addressing Adverse Childhood Experiences is a crucial step in disrupting the cycle of homelessness and promoting long-term health outcomes for this vulnerable population.

Learn more about housing and healthcare for those experiencing homelessness at www.ifhomeless.org.