Inspiration from ACE Interrupters in Great Britain
Liz Gregory – passionate reformer Joint head of the child and family psychology service, NHS South East Wales For years, consultant clinical psychologist Liz Gregory was a lone voice. She and her closest colleagues at the NHS child and family psychology service in south-east Wales felt they were swimming against the tide of received opinion. Early on, Liz recognised that clinic-based therapy – the traditional form of treatment for people with mental health issues – was inappropriate for some of the most vulnerable families on their patch. “In the Welsh valleys, it might be three buses and a three-hour journey to get to a clinic, or they might be on a zero-hours contract and, if they have time off work, they lose their job,” Liz explains. “But there are other difficulties – psychological and emotional. For most problems, we use cognitive behavioural therapy and that requires you to attend regularly and do homework outside of the session. It’s got a huge expectation and what we’re saying is that some of our most vulnerable children and families aren’t in a place to do that.” In particular, Liz was concerned about children who were unable to engage with therapy because they were exhibiting a fight, flight or freeze response to trauma in their daily lives. “Clinics don’t fit that population,” she says, “really highlighting an irony that our mental health [system] was arranged around a structure that couldn’t help those most at risk of developing mental health problems.” Liz’s fight against what she saw as an increasingly medicalised way of understanding children’s distress, in a target-driven culture, eventually persuaded her to take a career break in 2013. She could only swim against the tide for so long without feeling completely defeated. “We went through some pretty tough times.” She temporarily left her job as joint head of the child and family psychology service and moved to Canada with her family. Three years abroad gave her time to reflect and absorb new ideas. In 2016, she returned to the fray, re-energised with a more devil-may-care attitude. “I remember coming back to work and seeing what must have been a Public Health Wales document about adverse childhood experiences and I read it and was like, ‘Hallelujah, oh my God!’ I couldn’t believe it was out there in public knowledge, having been our mantra and passion and frustration for all those years.” New research on the impact of adverse childhood experiences (ACEs) brought everything into sharp relief. “Suddenly this research recognised what happens in your childhood makes a “… This research recognised what happens in your childhood makes a difference not only to your mental health but to your physical health too, so everybody is interested and it’s difference not only to your mental health but to your physical health too …” got such a price tag attached to it, in terms of the cost to society.”
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