A conversation with WCASA’s Rose Hennessey, MPH
April is Sexual Assault Awareness Month (SAAM)! And, April 1–7th is National Public Health Awareness Month.
Last month, WCASA welcomed Rose Hennessey to our staff as the Prevention & Evaluation Coordinator. Rose studied at the University of Minnesota, where she was Violence Prevention Intern and coordinated college events for Sexual Assault Awareness Month. While doing this work she developed an interest in prevention and decided to do her Masters in Public Health Education at UCLA. There, she worked on Project Erin (Emergency Response Intervention Network) at the Children’s Institute, Inc. where she did case management on domestic violence cases with mostly Spanish speaking children and families. She was also therapeutic support advocate for their PCIT (Parentâ€Child Interaction Therapy) program.
SM sits down with Rose H.
WCASA’s Violence Prevention & Communications Coordinator sat down with Rose to discuss the intersection of public health and sexual violence.
You can view the interview via YouTube (15 min)
The following is an excerpted transcript of that conversation:
Stephen Montagna, Violence Prevention and Communications Coordinator: What made you want to pursue a degree in Public Health?
Rose Hennessey: When I was in my undergrad, I was a Biology major. I was interested in science and interested in that kind of research development; but I was also a prevention educator. So I was going into fraternities, and talking to… anyone in the community really; I think I counted more than fifty presentations when I was there. I thought: this is really where my heart is – preventing violence. Most people who go into the field, they’re maybe lawyers, or therapists, or advocates. And I just felt, I really want to do the prevention work. I remember sitting down with someone and saying “well, how do we prevent violence?â€, and they said “well, we use the public health modelâ€, and I said “what’s that?†– and they said “you should go learn about itâ€!
SM: So your prevention work actually pre-dated the public health, you actually saw the public health work as a means toward accomplishing a prevention goal?
RH: Yes.
SM: What’s the connection between sexual assault and public health? When someone said, “check out these modelsâ€, what did those models tell about – what did you learn from public health about sexual assault?
RH: I think that it doesn’t take much digging to look at the health impacts. Especially in sexual assault, we’re looking at the impact of STD’s, HIV, that’s I think the most obvious, clear link. I think I just read that 40% of IPV (intimate partner violence) or sexual assault [incidents] have a physical injury, that go with them. Whether thats a broken arm, scrapes, lesions, something like that; so we already see those health effects there, leading up to, unfortunately to death. And anything that is a cause of death I think can be linked to being a public health problem.
SM: I find myself using the comparison with the word pandemic. We think of an epidemic, an outbreak; a pandemic, something that spreads world-wide. Is that appropriate? Are public health practitioners making that comparison – sexual assault is just like a disease in some ways?
RH: Very much so.
SM: Different because it’s not caused by a biological agent, it’s caused by personal behavior. But still, in terms of how wide-spread it is, we can think of it as a pandemic.
RH: Yeah, and I think especially because we have been able to do things and see tangible prevention results, if it’s something we can prevent, just like we can prevent onset of diabetes…then the model of prevention from the public health framework is going to be a really good fit. And is a really good fit.
SM: What can the SA prevention movement learn from the Public Health movement?
RH: Well I think the nice thing about the public health background is this science-y, research background that they’re really bringing in. Especially in terms of surveillance and tracking systems, so some of these great national reporting systems – but even just the ability to track and measure things over time. I think that sometimes that’s not something that we’ve had the money or time or knowledge, resources in the sexual assault movement to always accomplish. I also think that if we’re going to invest time in prevention, we should be doing things that we think really work well, not just maybe feel good. And I think that’s something that the public health folks and their models have really taken in looking at those outcomes and making a commitment to continue the things that are effective, and modify those things that aren’t, or discontinue them.
SM: So what about the other direction? Do you think there’s anything the public health movement can learn from the SA prevention movement?
Well I think about this a lot; I feel like it’s very difficult for folks in public health to come into domestic violence, child abuse, sexual assault prevention. More so than it is to go into poison prevention, cancer research, or that kind of thing. And I think it’s because there’s such a strong root in social change work, in social organizing, this movement that has originated from feminist upbringing. When you look at the framing of violence prevention as a public health issue, I think the first real great documentation is 1979, there was a health report released in the United States… but that’s a pretty young movement. When you think about the movement of ending violence against women – I mean, this has been going on and on and on. The activism that you see in our movement, the number of people calling legislators to pass VAWA, the Take Back The Night events happening globally. We see some of that in Relay for Life, some of your breast cancer awareness [campaigns], but I don’t think the investment and the activism is as strong and I think that’s something that the public health movement could really learn from the sexual assault movement.
SM: As someone who started in the movement as a prevention person, there are times where prevention and advocacy can – for lack of a better term, metaphorically – “butt headsâ€, because advocacy is responding to the real experiences of survivors, and prevention people tend to play with hypotheticals. And because the movements really started as a sort of call for perpetrators to be [held] accountable. We know these crimes are perpetrated by individuals, or by groups, we want those people held accountable. When you’re talking about a public health model – taking a step back and trying to see the causes that lead to this, there can be a tendency for some people on the advocacy side to think that you’re actually letting the perpetrator off the hook. How do you mitigate that?
RH: That’s interesting. I think it’s something that would come up in certain contexts. I think it comes down to this idea that the act is never okay. Whatever is causing it is never okay. Now, if we just leave it at that, we’re not going to have enough knowledge to prevent it. So it’s important to take it another step. But, I think that that has been a tension; and holding those folks accountable – I was really excited when I saw WCASA’s state prevention plan because offender accountability is one of those objectives. And I thought, that’s really wonderful, because it’s making it really clear that in the midst of all of this we’re not going to forget, that if we live in a society where people can do whatever they want and are never held accountable, we’re probably not going to prevent this.
SM: Where would you like to see the SA prevention movement go? What are we not (yet) doing that we should be?
RH: Well, in my perfect world, where I have as much funding as I want, and time… I think that it’s really common that when we are doing prevention efforts we are only doing one thing because that’s what we have capacity to do. So maybe in this town they’re doing — you know, events for Sexual Assault Awareness Month; and maybe over here they’re doing a curriculum with their teens; and over here they’re doing something else. But, we know that if we’re really going to prevent sexual assault it’s got to be a multifaceted approach. And that it’s never going to be enough; that every input that comes at us as human beings, that’s pushing us in certain directions, that we’re not going to mitigate that with a one-hour presentation. I would like to see more multifaceted approaches that are really targeting multiple levels. And, with that I would really like to see more RCTs — or randomized controlled trials — of what’s going on, because when you’re looking at literature, if you’re looking for prevention, our evidence-based practices very frequently are based on one study that hasn’t been replicated in other settings and as we saw with the crime prevention stuff in the Chicago area — CeaseFire, when that was replicated in other cities they didn’t get the same results because the cities were different. But they got wonderful results in Chicago. So I think I would like to see more research done in a rigorous manner so that we know it’s effective and if we’re gonna talk about best practices we can be more educated about it. Specifically, in some of our unique communities, too, that really have different risk and protective factors that might not be targeted by some of those interventions made for the mainstream.
SM: When we think of the public health model, and Public Health Awareness Week going into Sexual Assault Awareness Month, what are some of the ways in which people can actually think in a public health way as they’re celebrating or marking the month? I know for instance, towards the end of the month we will have a lot of activities here in Dane County. We’ll have Denim Day. Is Denim Day a public health opportunity?
RH: I think a lot of the sexual assault awareness month events are in and of themselves, awareness. Any time we have an awareness event it’s a great platform to include prevention, and to think about those risk and protective factors; how can we talk about them? How can we engage in them? So, if were doing denim Day let’s talk about healthy sexuality at the same time. Let’s talk about would have healthy masculinity looks like.
SM: Steubenville [OH] Which is so much in the news right now, is that a good opportunity to have public health dialog?
RH: Well I think that using that framework is very good. There are times that the public health movement has been critiqued for not having enough of a social justice basis as well. And I think there is some very valid reasons for that claim. That’s something that’s really nice about working in our field, is that I think we bring I think we bring some of those social justice [sensibilities]. I’d say that having a public health discussion about that situation could definitely be the case. And anytime were talking about this also remembering a social justice framework, and bringing in some of those concepts can be really important.
Of trauma and healing…
May is National Trauma Awareness Month; to mark the occasion, WCASA reached out to our ally and colleague Jennifer Jones, Interim Executive Director at the Wisconsin Children’s Trust Fund for some insight and context.
Ms. Jones, a native of Beaver Dam, graduated from Marquette University with a BS in Social Work. Her work has taken her to Boston and then back to Wisconsin again, spanning the past twenty years.
(Stephen Montagna, Violence Prevention and Communications Coordinator) What drew you to children, children’s health & safety, and your work in this movement?
Jennifer Jones: The devastating impact of poverty on children and families, in particular is what drew me to the social work field. I immediately packed up my belongings the day after graduation and drove to Boston to begin my professional career immersed in addressing hunger and homelessness. After 8 years in Boston, I moved back to Wisconsin and with continued focus on improving the lives of children, began working specifically in the child welfare arena with the Department of Health and Family Services. The more deeply I engaged in child welfare practice and systems, the greater my awareness grew of the connection of poverty to child abuse and neglect and the importance of prevention. After several years in deep-end system work, I was hired to serve as the Associate Director of the Wisconsin Children’s Trust Fund with the responsibility for advancing a statewide agenda to promote child abuse and neglect prevention. In essence, I’ve been working with children and family related issues for my entire 20-year professional career.
What sort of connection does National Trauma Awareness Month have to the work of the CTF?
JJ: I think drawing attention to trauma is important – not just during this month but throughout the entire year. Trauma Awareness Month provides a venue for raising the issue of trauma on a broader level. The Children’s Trust Fund is particularly interested in trauma as it relates to children who are abused or neglected by their caregivers. I commend the Wisconsin Coalition Against Sexual Assault for using this month of May to expand the focus to include trauma associated with violence and abuse.
What is the significance of the ACE study and how does it relate to the work of CTF?
JJ: The original Adverse Childhood Experiences (ACE) study conducted by Drs. Rob Anda and Vincent Felitti from 1995-1997 was the first large scale study of its kind to document the significant and profound relationship that child abuse and neglect and other adverse experiences have on later adult physical and mental health outcomes. In 2010, in partnership with the Child Abuse Prevention Fund of Children’s Hospital, and the Departments of Health Services and Children and Families, CTF raised funds to include the ACE module in the Wisconsin Behavioral Risk Factor Survey. For the first time, we were able to examine and understand the prevalence and impact of adverse childhood experiences among Wisconsin adults. Our findings mimic those of the original ACE study – 56% of Wisconsin adults reported growing up with at least one ACE. The findings showed that certain ACEs were highly correlated with an ACE score of 4 or more. For example, of those individuals who reported growing up with a household member that was incarcerated, 64% reported having experienced at least 4 ACEs. Incarceration of a family member goes hand in hand with a number of other ACEs. For the Children’s Trust Fund, this raises a critical question about prevention – if we work with children now who are growing up with an incarcerated family member, can we mitigate exposure to additional adverse childhood experiences and ultimately reduce the negative outcomes associated with higher number of ACEs? The ACE findings – both the original study and Wisconsin’s data highlight why prevention efforts are so critical. If we can reduce the number of adverse experiences earlier in the lives of children, I believe, we can have a significant impact not only on their individual lives but on the many systems that serve them.
What are the connections between the work of the CTF and the sexual assault advocacy and violence prevention movement?
JJ: The Wisconsin ACE data demonstrated that ACEs tend to indicate a greater likelihood of other traumatic experiences. This is particularly notable given the CTF focus on prevention. Among those who were sexually abused, 28% have 2-3 ACEs and 57% have 4 or more ACEs. In addition, the strongest association in the Wisconsin data was between ACEs and mental health, particularly pronounced among adults reporting childhood physical and sexual abuse. Among adults who reported sexual abuse, the odds of frequent mental distress more than doubled. Frequent mental distress is defined as experiencing 14 or more “bad mental health days†out of the past 30 days. In a recent study by Cassandra Simmel, Et.Al., examining the relationship between the experience and disclosure of childhood sexual abuse and subsequent adult sexual violence, found that physical force during the childhood sexual abuse experience was significant in adult revictimization experiences. Consistently the research shows links between child maltreatment and sexual assault victimization. There’s a lot we can do together to have a positive impact on the lives of children and families in our state. This work is well underway through the Forward Wisconsin Initiative [PDF download], a collaboration working to enhance efforts to change social norms and community tolerance for violence. This collaboration includes representatives from the Wisconsin Departments of Health Services and Children and Families, the Wisconsin Coalition Against Sexual Assault, the Wisconsin Coalition Against Domestic Violence, the Governor’s Council on Domestic Abuse, the Child Abuse Prevention Fund of Children’s Hospital, Children’s Service Society of Wisconsin, and the Wisconsin Children’s Trust Fund.
What opportunities might National Trauma Awareness Month present to CTF, child safety advocates, and violence prevention practitioners to raise awareness and extend the reach of their messaging?Â
JJ: Awareness, in itself can be healing. The more individuals are aware of trauma and its impact on their physical and mental health, the greater their ability to begin recovery and healing from traumatic experiences. Dedicating a specific month to building and generating awareness of trauma is a vital component in the broader outreach and educational campaign. The ACE & Trauma Workgroup, convened by the Children’s Trust Fund and composed of key experts statewide has identified public awareness and education as a key priority for 2013 and beyond. However, it’s critical to take this work beyond building awareness by offering individuals and agencies meaningful strategies to address trauma in their individual lives and in the lives of clients. I look forward to a future theme and focus of National Trauma Awareness Month on adverse childhood experiences and the resulting impact on the health and well-being of children and families throughout Wisconsin.
Posted in Commentary.
Tagged with child sexual abuse, May, trauma, trauma informed care.
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By events – May 2, 2013