Alive and Well STL

Program Description

Launched in 2014, Alive and Well STL grew out of a community engagement process, looking for solutions to reduce health disparities. Community members expressed high levels of stress and a need for emotional supports. This conversation led to Alive and Well STL — an effort to make St. Louis a trauma-informed community. The initiative has translated science about the impact of trauma into community-based solutions with the goal of accelerating the adoption of trauma-informed practices. Starting with a media campaign, the initiative has spurred a community-wide conversation, generating more than 175 million impressions, more than 100,000 visitors to aliveandwellstl.com, and more than 37,000 users on social media platforms. More than 225 individuals have enrolled as Ambassadors, working to advance emotional wellness as a prevention strategy. Demand for trainings and support for organizations wanting to become trauma informed has grown quickly. With the Missouri Department of Mental Health, Alive and Well STL has provided trainings about the impact of trauma to more than 12,000 individuals in more than 250 organizations. In addition, Alive and Well STL is providing technical assistance to a broad cross-section of organizations interested in becoming trauma informed, as well as providing training in trauma-specific interventions for clinicians.

Creativity

Alive and Well STL is taking a community-wide approach to addressing the social, emotional, and health impacts of toxic stress and trauma. A hallmark of this approach has been the utilization of a strategic media campaign to engage all citizens. The messaging, platforms, and stories that comprise the campaign are all rooted in the voices and feedback of community members. The campaign began with partners that focused on the African American community—the St. Louis American, which is the nation’s largest African American newspaper, and Radio One, a leading urban radio company. The campaign later expanded to broadcast television by partnering with KSDK NewsChannel 5, the local NBC affiliate. These partnerships have resulted in accessible, relatable stories about stress and trauma, accelerating change across the region and enabling the development of training and community engagement programs that have reached significant scope and scale in less than two years.

Leadership

Alive and Well STL is a program owned by community and supported by a diverse group of organizational and individual stakeholders. As the program has grown, new lines of service have been developed to respond to community need. The St. Louis Regional Health Commission leads the initiative with technical support from the Missouri Department of Mental Health, which developed the Missouri Model of Trauma-Informed Care. This model serves as the platform for all of Alive and Well STL’s trauma-informed programming and, through the help of Alive and Well STL, is garnering statewide and national attention. Planning is currently underway to determine how to replicate the success of Alive and Well STL in other markets, beginning in Missouri.

Sustainability

Support for trauma-informed care has been elevated, with community members, service providers, and funders interested in continued investment. The Ferguson Commission, formed by the Governor of Missouri after the death of Michael Brown, Jr., recommended the implementation of trauma-informed care and support as a way to spur greater racial equity. As a response to these recommendations, local funders have prioritized activities that support the Commission’s findings, including Alive and Well STL. St. Louis also has attracted federal investments to support the work, including a SAMHSA grant: Resiliency in Communities after Stress and Trauma. Alive and Well STL also has designed its programming to be sustainable beyond the program. For example, a train-the-trainer model has resulted in more than 75 individuals providing introductory trainings, and all technical assistance for organizations is focused on developing internal capacity to adapt policies, system and cultures, so the work lives beyond the intervention.

Replicability

Alive and Well STL, through its multi-level approach focused on community awareness and support, organizational transformation through trauma-informed care, and increased access to trauma-specific interventions, provides a model for replication across the country. The Missouri Model for Trauma-Informed Care provides a strong basis for all communities, organizations, and institutions to adapt as guidance for their work. Finally, allowing community members to have meaningful input in the activities and direction of the initiative will be a critical component to replicating these efforts. While each community will want to tailor the approach to the experience of their residents, the overarching architecture of the campaign and services may be replicated to help communities more quickly realize the potential of becoming trauma informed.

Results/Outcomes

In addition to engaging a significant number of residents, change is occurring at the systems level. For example, university partners are including the research about trauma and toxic stress in their curriculum, helping to prepare future professionals. Professionals are convening their colleagues to develop standards for responding to the research about trauma in their practices. Medical providers are beginning to take notice. For example, the Missouri Hospital Association released a brief analyzing the prevalence of adverse childhood experiences based on admissions data, advancing the conversation with member hospitals. Early adopters in the medical community are implementing employee wellness programs to mitigate caregiver stress, incorporating training about the impact of trauma in employee orientations, and developing requirements that reflect a trauma-informed organization in job descriptions. More than 20 schools are advancing through the Missouri Model with several reporting fewer office referrals and out-of-school and in-school suspensions since beginning the work.