Adverse childhood experiences (ACEs) are strongly linked to developing substance use disorders later in life. For example, a male child with an ACE score of 6 or greater has a 46-fold increase in risk of becoming an injection drug user later in life compared to a male child with an ACE score of 0. In response to these stark numbers, Manchester, NH formed the Adverse Childhood Experiences Response Team (ACERT) in 2015. This innovative program has a two-pronged approach:

• An outreach team comprised of a first responder (e.g. police officer), a crisis services advocate, and a behavioral health professional that visits families with children immediately after an incident is responded to by the police, and connects children and their parents to appropriate services in the community
• Trauma-informed training to first responder populations and social service agencies to foster a competent, compassionate, and effective workforce around ACEs, trauma, and mitigation

More information on the program can be found in this case study, the news articles here and here, and the presentation here. For greater detail on ACEs in NH and the state's comprehensive response, see the reports here and here. The program has been replicated in other cities in NH.

The program has put together a community implementation guide for communities considering replication of this model.