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STATEMENT OF PURPOSE The purpose of this study is to examine if a relationship exists between adverse childhood experiences and adult mental health illnesses and hospitalizations. Having a better understanding of potential triggers and unresolved childhood traumatic events could improve treatment and discharge plans for patients after seeking help on an acute inpatient mental health unit. Two surveys are being used to determine if a correlation exists between symptoms and trauma. Currently the hospital issues the BASIS-32 (Behavior and Symptom Identification Scale 32 question survey) to determine areas of difficulty functioning in day-to-day life. This survey is part of the CQI+ measurement to assess mental health outcomes. The second survey, ACE Score (Adverse Childhood Experiences) comes from a study the Center for Disease Control used in the 1990s. From August of 1995 to March of 1996, the 9,508 patients from the Kaiser Health Plan responded to the survey following a medical evaluation. This questionnaire asks ten questions surrounding childhood abuse and household dysfunction. The initial study found correlations with these adverse childhood experiences and increased health problems and poor lifestyle decisions as adults. A similar mental health correlation (especially with depression) is discussed in literature. Using the ACE survey as an assessment tool on the Mental Health Unit can help provide a more succinct picture of some of the underlying issues contributing to chronic illness that examining behavior and symptoms avoids. STATEMENT OF RESEARCH METHODOLOGY Patients are routinely administered the BASIS-32 at admission and discharge by hospital clinical staff. The survey tracks whether or not patients feel they are experiencing less difficulty in the 32 areas at discharge than the week leading up to admission to the Mental Health Unit. The ACE survey is the same as the CDC original study. Permission to use the survey is explained on the ACE study website. Patients on the Mental Health Unit of Heartland Regional Medical Center will initially be offered the survey in a social work group setting by the researcher. If patient is not willing to participate in the group, the option to fill it out in private will be available. The same option will be offered to patients admitted after the group session. Participation is not mandatory, and patients with guardians or on police holds are excluded from the study. The unit is limited to adult patients, so no minors will be involved. The option to discuss the questions on the survey, including related feelings or memories, will be offered by the researcher. Medical records will be reviewed to determine diagnosis and history of mental health inpatient treatment. ANTICIPATED RISKS AND BENEFITS There are minimal risks associated with this study. The risks remain largely in an emotional response to the questions. Any emotional responses can be discussed with the researcher or any member of the Mental Health professional team. The benefits of the study include insight into triggers. This information could be beneficial to the patient as well as the staff. Greater understanding for providers about the connections between childhood trauma and adult mental illness provides more therapeutic options in maintaining stable, baseline mental health levels for patients. SUBJECT SELECTION The goal is 100 participants. Subjects will be adult patients on the Mental Health Unit of Heartland Regional Medical Center who agree to complete the surveys. Individuals who are on a police hold or who have been assigned a legal guardian will not be selected for participation. CONFIDENTIALITY The Mental Health Unit of Heartland Regional Medical Center is a very secure facility. The participant will sign their name on a consent form either agreeing to or not agreeing to participation in the ACE survey. These consent forms will be stored in the correct medical chart, locked in the nurse station. The ACE survey results will be locked in a filing cabinet on the unit. BASIS-32 information is stored independently of medical records. After data input is completed results of the survey will be shredded. Demographic information is kept in the hospital’s double password protected database. Viewing of this information will be limited to hospital’s secure network computers. No identifiable information will be stored with the survey results. All hard copies of any information will be shredded after data input is complete. PRIMARY SUPPORTING DOCUMENT Click for Word Document Final Report on 04-20-2013 Data collection for this study has been completed. There were no issues with data collection.