Mental Health Resources

June 2018 by Lisa Turner, Counselor


Joe (not his real name) is frantic. He is the caregiver for his elderly mother who has dementia. She is distraught and causing problems at the nursing home. The staff is asking him to help manage his mother’s situation, and he doesn’t know how. Joe has a life-long substance use disorder and is missing most of his teeth. He smokes and engages in other unhealthy coping skills when his anxiety gets too high – which it is most of the time. He has tried to stop drinking and smoking so many times, but alcohol and nicotine make his anxiety symptoms go away… for a little while. And when the anxiety comes back, so does the use of alcohol and cigarettes.

Joe is caught in a vicious cycle that is most likely the result of Adverse Childhood Experiences, or ACEs. ACEs are incidents that harm social, cognitive and emotional functioning and dramatically upset the safe, nurturing environments children need to thrive. Examples include childhood abuse (physical, psychological, sexual), and household dysfunction (substance abuse, incarceration of a family member, mental illness, adult violence, parental separation or divorce).

According to the Centers for Disease Control and Prevention (CDC), The CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study is one of the largest investigations of childhood abuse and neglect and later-life health and well-being. Adverse Childhood Experiences are common. Almost two-thirds of study participants reported at least one ACE, and more than one in five reported three or more ACEs.

ACEs are defined by a person’s answers to ten specific questions about their first 18 years of life. If an adult responded “once or more than once” or “yes” to a question, they were considered to have experienced that category of ACEs. An ACEs score is determined by the total categories an adult reported experiencing, with a total possible score of eight. The ACEs data only measures categories of ACEs, not frequency or severity of each ACE. The categories of questions are as follows:

Emotional abuse: How often did a parent or adult in your home ever swear at you, insult you, or put you down?
Physical abuse: Before age 18, how often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way? Do not include spanking.
Sexual abuse: How often did anyone at least 5 years older than you or an adult ever touch you sexually, try to make you touch them sexually, or force you to have sex?
Substance abuse in home: Did you live with anyone who was a problem drinker or alcoholic, used illegal street drugs, or abused prescription medications?
Incarcerated family member: Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility?
Family member with mental illness: Did you ever live with anyone who was depressed, mentally ill or suicidal?
Domestic violence: How often did your parents or adults in your home ever slap, hit, kick, punch, or beat each other up?
Separation/divorce: Were your parents separated or divorced?

As the number of ACEs increases so does the risk for the following (this list is not comprehensive):

  • Alcoholism and alcohol abuse
  • Chronic obstructive pulmonary disease
  • Depression
  • Fetal death
  • Health-related quality of life
  • Illicit drug use
  • Ischemic heart disease
  • Liver disease
  • Poor work performance
  • Financial stress
  • Risk for intimate partner violence
  • Multiple sexual partners
  • Sexually transmitted diseases
  • Smoking
  • Suicide attempts
  • Unintended pregnancies
  • Early initiation of smoking
  • Early initiation of sexual activity
  • Adolescent pregnancy
  • Risk for sexual violence
  • Poor academic achievement

An Iowa study of ACEs found that more than half of all Iowans (56 percent) reported at least one ACE. “Fourteen and a half percent experienced four or more ACEs, indicating a significant level of childhood trauma that greatly increases the risk of poor outcomes.” (Beyond ACEs: Building Hope and Resiliency in Iowa)

Why do ACEs matter? According to IowaACEs360, people who report four or more ACEs are two times as likely (as those reporting zero ACEs) of reporting their health as poor or fair; two and a half times as likely to rate their mental health as “not good;” and two and a half times as likely to report limitations to their physical activity due to physical, mental, or emotional problems. Those reporting four or more ACEs are also more likely to be developmentally delayed, and/or suffer from depression.

According to a white paper published by the United Way of Central Iowa, Iowa’s adult population has health problems strongly associated with ACEs. In 2010 an estimated:

  • 66 percent of Iowans were overweight or obese
  • 8 percent had been told they were diabetic
  • 6 percent pre-diabetic
  • 8 percent had cardiovascular disease
  • 6 percent were current smokers
  • 23 percent were former smokers
  • 5 percent were heavy drinkers
  • 17 percent were binge drinkers

So back to Joe. Joe has a substance use disorder, both alcohol and nicotine, as well as emotional struggles with anxiety. His inability to think clearly might point to a developmental delay when he was younger. Joe is a good example of someone who is living with an ACEs score of four or higher.

Research has shown that early intervention for mental health and substance use disorder increases the chances of recovery exponentially. During the summer, this space will further explore the impact of ACEs on children and adults, and the best form of treatment for both. For more information, or to talk to a counselor, go to, or call 800-772-2758.

Most merciful God,
bless all who have suffered trauma
in their lives.
Support them with love
during their time of shock.
Grace them with peace
as they wrestle with the challenges
of each day.
Sustain them in hope
as they prepare for the days ahead.


Van Der Kolk, Bessel M.D., The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin, 2014

Corsi, Jasmin Lee, MS, LPC. The Emotionally Absent Mother: A guide to self-healing and getting the love you missed. The Experiment, 2010

Past Issues

January 2018 – Why do I Feel So S.A.D.(click to read more about Seasonal Affective Disorder)

February 2018 – Nothing to Fear…But Anxiety (click to read more about Anxiety)

March 2018 – Self-Esteem (click to read more about Self-Esteem)

April 2018 – Self-Care (click to read more about Self-Care)

May 2018 – Removing the Stigma of Mental Illness (click to read more about Removing the Stigma of Mental Illness)