Trauma Creep: Attack the HHS Mental Health Boondoggle To Reform America’s Health System

Robert F. Kennedy, Jr. Must reform the Department of Health and Human Services' misguided focus on "trauma."

This report originally appeared at Restoration of America News and is reprinted with permission.

George Orwell gave English-speaking readers the idea that language control equals control of a population. His obvious inspiration was the Soviet Union, and his magnum opus, 1984, is read as a commentary on explicitly communist governments. But the language control Orwell wrote about isn’t necessarily limited to Eastern Europe, or to totalitarian states. As the Soviet dissident Joseph Brodsky said in the 1970s or 1980s, “You Americans…You think evil is going to come into your houses wearing big black boots.  It doesn’t come like that.  Look at the language. It begins in the language.”

Examples of language control abound in the Washington, D.C. bureaucracy, but perhaps no better example exists than that of the Department of Health and Human Services’ (HHS’s) language around trauma. Beginning in the early 1990s  in the flush of America’s victory over communism, Republican politicians took their eyes off the deep state ball. Since then, "trauma creep" has become possibly the most insidious linguistic prong of Washington, D.C.’s control over Americans’ lives. This language game has flowed from HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA); HHS’s Centers for Disease Control and Prevention (CDC); and HHS’s National Institutes of Health (NIH). At the hands of these sub-agencies, “Trauma-informed” initiatives have spread throughout society in ways that disempower Americans—and distract from real problems faced by regular people. 

The biggest trauma boondoggle has come in education, in cooperation with academic-and-nonprofit backers of Social Emotional Learning (SEL) and Restorative Justice, which Restoration News has reported on extensively. Investigating the combination of government-corporate-backed language games and new academic-nonprofit educational theories shows the rise of an insidious project of social control whose victims are America’s children.

(READ MORE: The Fauci Pardon Proves He's a Monster)

Radically Redefining Trauma

Beginning in the 1970s, as the Vietnam War wound down and returning soldiers experienced psychological symptoms from their ordeal—post-traumatic stress disorder, or PTSD—trauma has been a widely accepted term in the psychological community. But it’s been understood to mean a specific thing. As the American Psychological Association (APA) tells it,

Trauma is an emotional response to a terrible event like an accident, crime, natural disaster, physical or emotional abuse, neglect, experiencing or witnessing violence, death of a loved one, war, and more. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships, and even physical symptoms like headaches or nausea.

This is a straightforward definition—trauma as a response to an extraordinary event—that most people can reasonably agree on. But it’s a definition that began changing in the 1990s, most clearly at the hands of the Department of Health and Human Services (HHS), specifically its Substance Abuse and Mental Health Services Administration (SAMHSA), founded in the early 1990s. According to its website,

SAMHSA describes individual trauma as an event or circumstance resulting in: physical harm, emotional harm, and/or life-threatening harm. Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.

Notice the key difference: the subjectivity. For the APA, trauma has to be a specific “terrible” event: “an accident, crime, natural disaster, physical or emotional abuse, neglect, experiencing or witnessing violence, death of a loved one, war, and more.” For SAMHSA, trauma “results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening.” The phrase used by SAMHSA, “experienced by an individual,” is the fundamental switch. Under the APA’s definition, a limited number of events qualify as trauma. Under SAMHSA’s, anything can qualify.

SAMHSA pushes Trauma…

On one level, it’s clear why SAMHSA made this extreme shift: a lack of competence in personnel. SAMHSA’s first director, appointed by President Clinton in 1994, was Nelba Chavez, who had been serving as director of juvenile probation services for San Francisco; in the eyes of many in Washington, her “few years of experience in city office did not provide a background to credibly run a federal agency with a budget of more than $800 million.” What’s more, “her acerbic and domineering style…contributed to an exodus of well-known experts from the agency.”

Lacking guardrails, Chavez proceeded to fund studies into trauma, and SAMHSA came up with a “trauma-informed model” for organizations to adopt to ensure they are “trauma-informed,” e.g. “fully integrating knowledge about trauma into policies, procedures, and practices; and seek[ing] to actively resist re-traumatization.”

But incompetence wasn’t the only reason for SAMHSA’s trauma turn; instead, trauma was part of a broader medical shift. Indeed, under Chavez’s well-regarded, George W. Bush-appointed successor Charles G. Curie, who “stabilized” SAMHSA and quieted calls for its dismantling, the institution doubled down on Chavez’s trauma focus: founding the National Center for Trauma-Informed Care in 2005. By 2014, eight years after Curie’s departure, SAMHSA’s “trauma-informed” initiatives included

SAMHSA’s National Child Traumatic Stress Initiative, SAMHSA’s National Center for Trauma Informed Care…SAMHSA’s…Jail Diversion Trauma Recovery grant program; Children’s Mental Health Initiative; Women, Children and Family Substance Abuse Treatment Program; and Offender Reentry and Adult Treatment Drug Court Programs.

Also by 2014, SAMHSA was providing funds for the nonprofit the Center for Healthcare Strategies, an initiative founded in the early 1990s for “identifying and demonstrating best practices in Medicaid managed care” which by the 2010s had incorporated trauma into its brief. It could report that, thanks in part to these efforts,

Oregon Health Authority is looking at different types of trauma across the age span and different population groups. Maine’s “Thrive Initiative” incorporates a trauma-informed care focus in their children’s systems of care. New York is introducing a trauma-informed initiative in the juvenile justice system. Missouri is exploring a trauma-informed approach for their adult mental health system. In Massachusetts, the Child Trauma Project is focused on taking trauma-informed care statewide in child welfare practice. In Connecticut the Child Health and Development Institute with the state Department of Children and Families is building a trauma-informed system of care throughout the state through policy and workforce development. SAMHSA has supported the further development of trauma-informed approaches through its Mental Health Transformation Grant program directed to State and local governments.

…and so does the Centers for Disease Control and Prevention (CDC)…

Meantime, another department in HHS, the Centers for Disease Control and Prevention (CDC), was lending its credibility to trauma creep. In 1998, under its Clinton-appointed Director David Satcher, the CDC funded a study by Kaiser Permanente (also a funder of the Center for Health Care Strategies) on “Adverse Childhood Experiences” or ACEs. Nowhere in the results of this study was the word “trauma” mentioned, but the study nonetheless became the “seminal” text that “proved” the “traumatic” effects of childhood experiences on adults. According to the study, “more than half of respondents” in a sampling of about 9,000 people “reported at least one, and one-fourth reported 2 categories of childhood exposures” to “childhood emotional, physical, or sexual abuse, and household dysfunction during childhood.” These were the “Adverse Childhood Experiences” which the study purported had a relationship to “health risk behavior and disease in adulthood.”

Digging into the study raises questions about its reliability. The 9,000 people who responded to the study’s survey were self-selected from 13,000 people mailed—meaning they had the time or the inclination to think about the questions. The “exposures" these respondents were asked about were extremely open to interpretation: they included whether a parent would “often or very often…put you down?”; “act in a way that made you afraid that you would be physically hurt?”; was a “problem drinker or alcoholic”; or was “depressed or mentally ill.” Additionally, the current “health problems” the respondents experienced as a purported result of these “exposures” could be construed as normal parts of modern life: they included being a “current smoker”; having “no leisure-time physical activity”; and experiencing “two or more weeks of depressed mood in the last year.”

Finally, the study, which served to create more patients for pharmacological care based on diagnosing a whole new vista of mental health “traumas,” was carried out by Kaiser Permanente and commissioned by CDC director David Satcher—and Satcher, within five years, was working for Kaiser Permanente.

This extremely skewed study nonetheless became the gold standard for the next twenty-five years—cited by the increasing number of government practitioners who wanted to spend funds on addressing trauma and its purported lifelong effects on children. 

…and the National Institutes of Health (NIH)

The last HHS player enabling trauma creep was the HHS’s National Institutes of Health (NIH), under its director from 2009 to 2021, Francis Collins. This began before Collins’s tenure, with the NIH’s embrace of an increasingly wide swath of “mental health disorders” promoted by the (APA) in the early 2000s. Even Liberal critics have argued that this definition expansion was largely pushed by psychiatric professionals for their own and their pharmacological allies’ benefit: creating more disorders meant more diagnoses, more prestige for psychiatric professionals, and more prescription medications for pharmaceutical carriers like Kaiser to fill. But, despite its embrace of an ever-expanding manual of mental disorders, the NIH hadn’t yet jumped the breaker when it came to redefining trauma away from the APA’s original, limited definition.

The rubber met the road during Collins’s tenure, when the NIH, a 138 year old institution considered the “crown jewel” of the country’s government-backed health research, funded projects that promoted the need for “Trauma-informed” practices far beyond any clinical psychological approach. These projects also lent the NIH’s credibility to SAMHSA’s definition of trauma, arguing that SAMSHA’s definition of trauma as occurring off not just a terrible event but a “a set of circumstances” effectively “acknowledge[s] the role of social traumas, arguably overlooked [by the APA].” From there, it was a short step to defining these “social traumas” as including  

community, social, cultural and historical traumas such as racism, poverty, colonialism, disability, homophobia and sexism and their intersectionality.

Trauma Creep Comes to School via Criminal Justice…

Beginning in the 1990s, this HHS trend—SAMHSA, the CDC, and the NIH lending their credibility to trauma as a broad-based phenomenon—converged with the focus on “social traumas” pushed by criminal justice practitioners.

Remember, SAMHSA founding director Nelba Chavez, who kicked off the trauma push at HHS, came to SAMHSA from running a “criminal justice clinic.” As Restoration News will reveal in a soon-to-be-released report, many of the worst ideas that have found their way into the criminal justice and education system have come from “criminal justice clinics” and their “juvenile probation services” counterparts. This was thanks to these operators’ focus on helping remediate young criminals without using incarceration, which they did by excusing criminals’ actions based on psychological theories of personality development.

Their loosely applied theories of criminal motivation ignored obvious social problems that encouraged urban criminals to act out (like labor outsourcing that lost black fathers’ jobs) in favor of focusing on “traumas” at home. The result of this theorizing were “alternative justice” initiatives like “Restorative Justice,” which undercut the legal system’s commitment to crime and punishment in the name of servicing child offenders’ traumas.

…And Social Emotional Learning 

Chavez’s juvenile justice system wasn’t the only one pushing these ideas. The same loose theorizing was being backed by actual child psychologists at government-funded universities, especially Yale. As Restoration News has reported, Dr. Peter Salovey, a noted child psychologist at the university and later Yale’s president, was a main source for Emotional Intelligence: the 1995 book written by then-New York Times reporter Daniel Goleman which introduced Social Emotional Learning (SEL) to American secondary education.

In Emotional Intelligence, Goleman argued without evidence that “the same circuitry” involved in PTSD is at work in “the more ordinary travails of childhood. According to Goleman, circumstances like “social rejection may never reach the fever pitch of trauma, but they surely leave their imprint on the emotional brain, creating distortions.” Since “distortions” in the brain could obviously affect learning, preventing these mini-“traumas” now became a legitimate task of schools, particularly at the hands of the Yale-founded nonprofit CASEL (the Collaborative for Academic, Social, and Emotional Learning). Notably, CASEL was funded, among others, by the Robert Wood Johnson Foundation, which also funded the Trauma-Informed Care Implementation Resource Center at the Center for Health Care Strategies.

By the 2010s, as Restoration News’s follow-up report will show, the deepest harms of this convergence were being experienced on the ground by America’s children.