Trauma-Informed Care and the Legal Professional

By Alicia Mitchell-Mercer

On Friday, November 16, 2018, I attended the Mecklenburg Resilience Symposium: Building Hope for Tomorrow Through Action Today with a number of judges, medical providers, and mental health professionals. The topic of the Symposium was community Resilience or the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress.

This was such a timely conference for the judicial system, which serves the needs of people affected by trauma everyday. The Symposium explained that Resilience is not a trait that people either have or do not have. It involves behaviors, thoughts and actions that can be learned and developed in anyone to help them persevere through difficult times.

The keynote address focused on understanding the effects of adverse child events and toxic stress on the human body and community all the way into adulthood. Additionally, a panel of experts discussed current programs proven to work along with strategies for implementation in medical, mental health, and legal organizations among others.

During the afternoon breakout sessions, participants were encouraged to brainstorm on current practices and on creative solutions to address toxic stress and building resilience in our communities. At the end of the day, we reconvened to share highlights from the breakout sessions in an effort to create a roadmap that will lead us to a more trauma-informed, resilient community.

Among the guest speakers were keynote speaker, Bruce D. Perry, MD, PhD, Senior Fellow of The ChildTrauma Academy who spoke on The Impact of Trauma and Neglect on Children (and how this affects them going into adulthood); Elizabeth Trotman of the Charlotte Resilience Project; A Legislative Perspective from Mecklenburg County DA Spencer Merriweather, City Councilwoman Julie Eiselt, County Com Elect Mark Jerrell and Rep. Carla Cunningham; Remarks by North Carolina First Lady Kristin Cooper; and Next Steps from Sara Horstmann, MD, Atrium Health

If you are unfamiliar with Dr. Perry, he is an American psychiatrist, currently the Senior Fellow of the Child Trauma Academy in Houston, Texas and an Adjunct Professor of Psychiatry and Behavioral Sciences at the Feinberg School of Medicine in Chicago, Illinois. He has spoken in Charlotte and many other areas in North Carolina to train judges, medical professionals, and mental health professionals on psychiatric matters related to a variety of topics including criminal justice, domestic violence proceedings, family law, and juvenile court proceedings.

Child Trauma and the Judicial System

Dr. Perry spent some time discussing childhood trauma and the prison pipeline as well as what we can do to help children and adults who are victims of trauma as they come through our organizations.

I thought I would share just a small excerpt of what I learned during this training session. There was so much that I took away from this program that could easily impact a case involving family law or criminal law. But, one of the most interesting highlights of this program was Dr. Perry showing us a genogram (both the maternal and paternal side) of one gentlemen who had been convicted of murdering 5 people. He discussed the man’s family history, and as he did so, he highlighted the names of the people in the convicted man’s “family tree” that had certain issues (ACEs or adverse childhood events) including alcohol/drug dependency, physical abuse, sexual abuse, criminal background, diagnosed mental health disorders, etc.

Out of the more than 50 family members depicted on this person’s genogram, very few people in his family had no ACEs and the majority of family members had multiple ACEs. There is a CDC website and a great NPR article on ACEs and the effects into adulthood. Links are posted at the end of this blog post. An ACE score is a tally of different types of abuse, neglect, and other hallmarks of a rough childhood. According to the Adverse Childhood Experiences study, the rougher your childhood, the higher your score is likely to be and the higher your risk for later medical and mental health problems and run-ins with the judicial system.

Another amazing fact, about this man who was convicted of murder, is that when Dr. Perry (and team) reviewed his birth records, they (hospital workers) had already identified him as coming from a “high risk family” at birth. They already knew he was in trouble the moment he was born. Yet, after more than 60+ contacts with various professionals in the medical and mental health fields, and a lot of documented instances of “calls for help,” the system failed. As a result, 5 people were murdered by this man because of our failed system..

Dr. Perry and his work are highly regarding in the judicial circuits as he’s the foremost MD and psychiatrist on trauma. I encourage you to research his work. DA Merriweather (Mecklenburg County) and Dr. Perry stressed how important it is that all who are part of the legal system need to be trained on identifying ACEs and how they affect our communities. If you work in family law where children are involved, we can do much to inform our clients of the impact of trauma on their children by providing them with trauma-informed care resources. If you work in criminal law or juvenile court, you can use this information to inform your client and the court about the impact of ACEs on the community and encourage them to seek help. As a part of the legal community, with a very unique opportunity to know our clients in intimate ways and serve the public at large, we need to take a more active role in spreading the word about trauma-informed care so we can prevent ACEs before they occur and help members of our community if they have already occurred.

Below I have included an ACEs test you can take for yourself. An increasing number of medical and mental health professionals are becoming aware of ACEs. ACEs is not a tool for “solving” a problem, but it can be used as a tool to help identify areas we need to address with the people we come into contact with in our communities. The ten questions asked on the ACEs test may be a useful informal screening tool for attorneys/paralegals who work in the legal system depending upon your practice area.

Take the ACEs quiz

Information from CDC on ACEs.

If you have questions or comments, please let me know and I’ll be happy to answer them or point you in the right direction to some helpful resources.

Alicia Mitchell-Mercer is a senior litigation paralegal and legal project manager at Brown & Associates, PLLC and a consultant for LexPM Consulting in Charlotte, NC.

Ms. Mitchell-Mercer has a BS in Paralegal Studies and a MS in Project Management. She speaks at conferences regarding legal project management and best practices for improving inefficiencies, maximizing profit, and providing a better client experience.

Ms. Mitchell-Mercer is certified by the NC State Bar, SC Bar, National Association of Legal Assistants, and National Federation of Paralegal Associations. Ms. Mitchell-Mercer holds advanced paralegal certifications in Contracts Administration, Trial Practice, Business Organizations: Incorporated Entities, and E-Discovery.