Study: Insufficient Mental Health Care for Adults with Tough Childhoods

A new study conducted by the UCLA Center for Health Policy Research reveals that while 20% of California adults reported having four or more adverse childhood experiences, nearly 40% from this group expressed an unmet mental health need in the past year. Adverse childhood experiences (ACEs) encompass physical and emotional neglect; physical, sexual and emotional abuse; as well as household challenges such as intimate partner violence, divorce or parental separation -- including living with any individual involved in criminal activities or grappling with a mental illness and/or substance use disorder. 

The research utilizes data from the 2022 California Health Interview Survey which highlights how ACEs can disrupt healthy brain development and modify physiological responses to future stressful situations. Preventing these adverse experiences may mitigate serious conditions like depression and cardiovascular disease, socio economic issues like unemployment, along with negative behaviors such as heavy drinking and smoking during adulthood. 

Sean Tan, senior public administration analyst at the UCLA Center for Health Policy Research stated: "This study helps us more clearly understand how our childhoods shape the adults we become, particularly our mental well-being." He emphasized on better screening methods for ACEs during routine health care visits to improve both physical and mental health outcomes. 

When analyzed by smaller demographic groups: 

- Positive childhood experiences before age 18 were found protective against detrimental effects of adverse ones. These positive instances include feelings of safety at home during their formative years along with a sense of belonging in high school. 

- Younger adults had higher rates of ACEs but fewer positive ones compared to older individuals. 

- Almost two-thirds (65%) of elderly respondents reported having four or more beneficial childhood encounters versus just over half among younger cohorts aged between 18-35 (52.6%) & 36-49 (54.5%). A total of 10.8% claimed no positive early life experience whatsoever. 

A law passed in California last year requires healthcare insurers to reimburse hospitals conducting screenings for ACEs among children and adults. The report suggests extending this training requirement to all insurance providers, not just those seeking Medi-Cal reimbursements, to encourage widespread adoption of ACE screenings and intervention protocols. 

The report also advocates for the development of awareness campaigns targeting populations insured by Medi-Cal given that the percentage of beneficiaries screened for ACEs ranged from a meager 0.2% in Colusa County to a significant 39.6% in Orange County among young individuals up to age 20. 

"Given that Medi-Cal serves low-income households in California," Tan said, "the state needs to ensure that the neediest Californians have access to these difference-making types of care." 

The study praises the work done by initiatives such as ACEs Aware which aims at raising knowledge about impacts of adverse childhood experiences on long-term health outcomes. 

On May 3rd, California launched its Live Beyond campaign aiming at expanding understanding around potential impacts of ACEs on everyday lives while providing tools and resources for managing stress and preventing cyclical transmission into future generations. 

Tan concluded: "As society has made progress in destigmatizing discussions about mental health...our study shows we still have a long way to go in terms of providing services and treatment.”