West LA Times

A recent study by the UCLA Center for Health Policy Research has found that adults who have experienced adverse childhood experiences (ACEs) are not receiving adequate mental health care. According to the study, one in five California adults reported four or more ACEs, with this proportion being even higher among young adults and certain racial or ethnic groups.

ACEs encompass a range of difficult experiences including physical or emotional neglect, various forms of abuse, and household challenges such as intimate partner violence, divorce or parental separation. They also include living with someone involved in the criminal justice system or struggling with mental illness and/or substance use disorder.

The study, which utilized data from the 2022 California Health Interview Survey, highlighted that ACEs can disrupt healthy brain development and alter how the body responds to future stressful experiences. Prevention of ACEs could potentially reduce a broad range of serious conditions such as depression and cardiovascular disease, socioeconomic challenges like unemployment, and behaviors like heavy drinking and smoking in adulthood.

Sean Tan, senior public administration analyst at the UCLA Center for Health Policy Research and lead author of the study said: “This study helps us more clearly understand how our childhoods shape the adults we become, in particular our mental well-being.” He added that better screening for these adverse childhood experiences during routine health care visits could have far-reaching benefits for both physical and mental health.

Among its findings, the study revealed that younger adults in California (ages 18–35) were twice as likely as adults 65 and older to have had four or more ACEs. Of those who had at least one ACE, nearly half (47.9%) of those aged 18-35 reported an unmet need for mental health services in the past year compared to 21.4% of adults aged 65 and older.

In terms of racial or ethnic groups, larger proportions of adults identifying as American Indian or Alaska Native (36.8%), multiracial — two or more races (27.3%), Black or African American (25.9%) or Latino (24.2%) reported having had four or more ACEs compared to all adults (20.1%).

The study also emphasized the protective role of positive childhood experiences, such as feeling safe and protected at home, feeling that their family stood by them during difficult times, and feeling a sense of belonging in high school.

To address the effects of ACEs, the report recommended expanding ACEs screening training requirements for all insurance payers and developing new awareness campaigns to increase screenings for adverse childhood experiences, especially for populations insured by Medi-Cal.

Tan stressed the importance of health equity: “Given that Medi-Cal serves low-income households in California, the state needs to ensure that the neediest Californians have access to these difference-making types of care.”