(C) Daily Yonder - Keep it Rural This story was originally published by Daily Yonder - Keep it Rural and is unaltered. . . . . . . . . . . How Communities Are Reframing Trauma and Rebuilding Pathways to Healing [1] ['Caroline Tremblay', 'The Daily Yonder', '.Wp-Block-Co-Authors-Plus-Coauthors.Is-Layout-Flow', 'Class', 'Wp-Block-Co-Authors-Plus', 'Display Inline', '.Wp-Block-Co-Authors-Plus-Avatar', 'Where Img', 'Height Auto Max-Width', 'Vertical-Align Bottom .Wp-Block-Co-Authors-Plus-Coauthors.Is-Layout-Flow .Wp-Block-Co-Authors-Plus-Avatar'] Date: 2025-07-09 Rural communities face unique challenges when it comes to trauma and healing. Whether it’s a school district, healthcare provider, or small-town library trying to support community well-being, trauma-informed care needs to be tailored to local realities, like geographic isolation and limited access to services. “It’s about understanding the impact of trauma on those we serve, our workforce, and each other, and using that information to do things differently or better,” said Mandy Davis, LCSW, PhD, director of Trauma Informed Oregon (TIO). TIO was born from a unique, statewide partnership that began in 2014, when the Oregon Health Authority teamed up with Portland State University, Oregon Health & Science University, and the Oregon Pediatric Society. Originally focused on child and family-serving systems, the initiative expanded in 2015 to include adult behavioral health. Part of the challenge TIO has faced is that most policies shaping trauma-informed care are designed for urban systems. “Translating those can cause a lot of tension in the rural areas,” Davis said. That’s why tailoring policies to the realities of rural life—whether it’s population, geography, or funding—is essential. Beyond Oregon, rural communities across the country are deepening their understanding of how trauma shapes addiction, violence, school struggles, and chronic illness, building on decades of work by advocates, clinicians, and organizers. Tailored Approaches to Trauma According to the Centers for Disease Control and Prevention, 63.9% of U.S. adults report at least one Adverse Childhood Experience (ACE), and 17.3% report four or more. These preventable, potentially traumatic events, ranging from abuse and neglect to financial hardship or growing up with a caregiver who has mental health challenges, are linked to a host of long-term negative social, economic, and health outcomes. “All of these things are so trauma-driven, so leaving trauma out of the conversation is missing the point,” said Anena Hansen, project manager for Trauma Responsive Monadnock. Her organization comprises community members committed to bringing a trauma-informed lens to southwest New Hampshire, the first initiative of its kind in the state. But the national conversation around trauma-informed communities is not new; it’s been gaining momentum over the last several decades. Hansen pointed to Oregon, which she said “has really been a trailblazer in this.” From the beginning of TIO’s work, advocacy has been the common thread, Davis said. “We give everyone the same information and resources, but then that entity, community, or organization will make it look like theirs. So it’s going to look different in a library than at a preschool or a child welfare center,” Davis said. Based on lessons from early adopters, TIO’s mission has evolved over time. The greatest challenge is designing systems people actually engage with. Whether a solution is being offered for housing, healthcare, or food access, “community members need it to be done in a trauma-informed way so they can actually engage in those services effectively and efficiently,” Davis said. A significant part of the work revolves around healing from difficult times—perhaps a violent incident, natural disaster, or long-standing social issue, such as substance abuse. Davis said the framework for healing “resonates with people from all different sectors who see themselves impacted.” TIO spends a great deal of time working face to face with community members, offering training, support, and follow-up to drive these efforts forward. From Poverty to Access to Green Spaces, Trauma-Informed Care Takes a Holistic Perspective “People come together to see what’s working, with a real reminder that trauma-informed care also includes elements like access to healthy food and green spaces—all those things that prevent and also heal adversity,” Davis said. These interactions are what mental health professionals call Protective and Compensatory Experiences (PACEs), or positive experiences that promote healthy development and well-being. They are critical in rural communities where, “there is a statistically higher likelihood of unmet needs escalating into trauma-causing situations,” Hansen said. For instance, poverty can both cause and exacerbate trauma, as well as inadequate healthcare access for physical or mental needs. The nonmetropolitan, or rural, poverty rate was 15% in 2019, compared to 12% in metropolitan counties, according to the USDA’s Economic Research Service.And Feeding America reports that while rural areas comprise less than two-thirds of all US counties, nine out of 10 counties with the highest food insecurity rates are rural. While these challenges are significant, Davis noted that rural communities often show remarkable resilience, and it can be profound to watch people come together. Shared services, creative partnerships, and a willingness to act quickly can accelerate progress when there’s community buy-in. From education and healthcare to the legal system and disaster response, “there are multiple pathways to trauma-informed work, so we’re keeping up with a lot of different sectors,” Davis said. It can, at times, feel inundating for the people on the ground. So as part of its consulting model, TIO has started offering free micro lessons, like trauma-informed decision-making, implementation, and boundary-setting, skills that communities expressed needs for. Davis described the work as both rewarding and overwhelming; there’s no one-size-fits-all approach. She came to this work through the years as a social worker, clinician, and provider in sexual assault and domestic violence services. What stood out, she said, was that healing often became “less about the intervention and more about connection.” Davis saw people healing and doing amazing work—until systems got in the way. By “systems,” she meant the institutions meant to serve people: healthcare, law enforcement, education, mental health services, and the courts. For Davis, trauma-informed care must support individuals while also holding these structures accountable. “Systems either create trauma, activate old trauma, or get in the way of the healing process,” she said. But trauma-informed communities create space for change. “I can’t often change what’s already happened, but I can influence how the system treats you and impacts you,” Davis said. To start that shift, Hansen said, “normalizing the conversation is crucial.” But creating lasting change, both Davis and others agree, begins with building a shared understanding of how trauma affects us and the systems we rely on. “I want my neighbors to have foundational knowledge about how toxic stress, scarcity and trauma impact our brains, bodies, and ability to engage with one another and with services,” Davis said. “Knowing that, how might we show up for ourselves and each other?” Caroline Tremblay is a freelance writer who assists with news coverage of Radically Rural, an annual summit on rural issues held in Keene, New Hampshire. This year’s event, featuring people and organizations cited in this story, is Oct. 7-9. For more information, and to register for this year’s summit, visit radicallyrural.org. Related Republish This Story Republish our articles for free, online or in print, under a Creative Commons license. 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