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Tarrant County 5 Stones April 2023 Meeting

Here is our recorded meeting link and chat notes for our April 2023 TC 5 Stones meeting!

Our 5 Stones meeting this April consisted of some updates and a presentation by Mary Ann Contreras, RN with JPS Health Network. Mary Ann discussed the intersection between intimate partner violence and trafficking.

Here is the link to the recorded meeting:
https://cutt.ly/5StonesApril2023Video

Here is a link to the presentation:
https://cutt.ly/5StonesApril2023Presentation

The chat log is how our audience was able to introduce themselves and their agencies. Here is the link to the chat log:
https://cutt.ly/5StonesApril2023ChatLog

This month we had 2 agency announcements:
Carly Brown & Natalie Salinas – A21
A21 operates a day resource center for survivors called the Freedom Center in Irving. They work with both men and women, and labor and survivors. They also have many tools and .
Sarolyn Morgan – HSI
Homeland Security Investigations is hiring 62 people for forensic interviewers and victim assistance specialists. The jobs will post on www.USAJobs.gov over the next 6-8 weeks.

For those wanting to get more involved, follow the link below to see a list of ways you can participate in anti-trafficking efforts!

How Can I Help List:
https://cutt.ly/w4BrMv5

Thank you for joining us!

Felicia Tallent, Founder
Tarrant County 5 Stones Taskforce

TC 5 Stones April 2023

Our 5 Stones meeting this April consisted of some law enforcement updates and a presentation by Mary Ann Contreras, RN with JPS Health Network. Mary Ann discussed the intersection between intimate partner violence and trafficking.

Mary Ann Contreras, RN – Mary Ann has practiced nursing over four decades, specializing in the field of trauma, emergency and critical care. Currently, she is the Injury and Violence Prevention Manager at JPS Health Network in Fort Worth, Texas. Mary Ann trauma, behavior, environment and policy to develop, implement and evaluate prevention strategies and initiatives. She enjoys multi-disciplinary coalition work focusing on prevention and improving the health and safety for the community. She is involved in professional education for trauma healthcare providers, advocating and educating for proficient patient care in trauma centers and within trauma systems. Mary Ann believes positive community change is influenced by strengthening individual knowledge, promoting community and provider education, fostering coalitions and networks, changing organizational practices and influencing policy and legislation.

Unedited YouTube Transcript

this is great we have a school room today um we're gonna have an amazing
presentation in a little bit um so we're gonna jump right into it and have some a time of announcements
um before we uh get started I do want to say uh thank you to catering to love for
providing food today
also um anybody any of the agencies that are five Stones Partners please know we do
have grant money available so if you want to apply for that uh please email me and I will get you the application if
you're not a five Stones partner and your agency wants to be email me and I will help you with that process as well
our Spotlight agency this month is a21 so I'm going to have them come up and
introduce themselves good morning everyone my name is Natalie
this is Carly and um we're with 821 this morning we just wanted to come by and
share just a little bit of the resources that we have I have information at the table outside in the hallway when you
leave today feel to stop by and chat with us but we have so many amazing resources
um for Education prevention and awareness and those can be utilized in family units at churches schools there's
so many different opportunities that we can continue to raise awareness and partner with local communities and so um
if you're interested in learning more about the resources that we have feel free to stop by yeah and I oversee our
Aftercare team and so we work directly with survivors providing crisis response and long-term advocacy we work with both
men and women as well as labor and sex tracking survivors and we office out of our freedom Center in Irving which
operates like a day Resource Center for survivors already in our care and so like Natalie I'll be out by our table
off the meeting would love to connect with you guys thanks so much
all right do we have any other agency announcements
yeah no I know we have one no I need you up here just so our online
crowd can see you too good morning everybody
my name is Sarah Lynn I work with Homeland Security investigations and I
wanted to let you know that we are hiring 62 individuals forensic interviewers and Victim Assistance
Specialists across the United States the jobs will post on USAJobs probably
within the next four to six weeks so if you are interested if you are a
high-speed clinical and Trauma informed um individual who has been doing this
work we are looking for you so um apply at USAJobs
oh all right any other agency announcements
okay then we'll go ahead and move into our law enforcement updates and we'll start with Fort Worth PD and detective
Matthews
how do y'all feet so it may look like we've
totally eradicated human trafficking not quite great so this last month we've
only got had uh five cases and two tips come in um with that we've not had any outcries
so we don't have any workable cases yet but we still have a pretty hefty caseload with all the other cases we're
working um did want to say uh mention that one of
our one of the tips came in that we are still looking into even though there's not an outcry it came from the school
resource uh people uh I don't know if it's a counselor just one of the employees there staff
but just notice some concerns with one of their students and it's not the first time we've had that so just want to let
you all know I mean our schools do watch for uh children who were possibly victims of
trafficking um
I was hoping also look for any uh prosecution updates but we don't have
any of those yet for you so sorry about that but I will say uh on a lighter note
we did go to a two-day training last week our whole unit
and uh it was all about uh open source investigations
basically learning how to use Google and advanced searches to look for stuff
that's just openly posted on the internet to help us identify and Target victims and uh find evidence
for for our cases and stuff so it was really uh really enlightening a lot of information and uh it was really helpful
so that's about it hopefully I'll have more for you next month thank you
and next we'll hear from Tarrant County Sheriff's Office and detective Clark
um hello um I did bring my notes because I wanted to make sure I mentioned several agencies
um without a big group we wouldn't be able to do this so um in the month of April Tarrant County
Sheriff's Office partnered with North Texas Human Trafficking task force Arlington PD Cook County Sheriff's
Office Denton County Sheriff's office Gainesville PD Fort Worth PD Lake Worth
PD Mansfield PD um DPS and the 's
office um and also we use five stones and other
victim service providers that conduct the following operations so with this month our first operation um we did a
two-day demand suppression off the operation was hosted by HSI and Lakeport PD there were 42 arrests made in Lake
Worth um the second operation was also a demand suppression up it was held in
Gainesville and the operation was hosted by the Texas Department of Public Safety and Cook County Sheriff's Office as a
result of that operation there were 14 suspects arrested for solicitation of prostitution and one of the suspects was
identified as a five Deuce Crips gang member and has he and he has many entered into the gangster films
um previously on March's report we spoke about a um research warrants that we did for
child pornography those were successful and the detective work in
those um is done three search warrants for the electronics that were collected at the
individual houses so um that'll take a while to get back but um we are busy and
um we look forward to talking to you next month
all right before we continue we have one more exciting updates
good morning everyone for those who don't know me I'm Amanda nickname I'm with the Tarrant County criminal District Attorney's office I just wanted
to give you a quick update we actually have uh my co-counsel Juana ravala just
had a revocation hearing this morning where we had a female who was kind of
working as a bottom um just had she was out on a deferred a probation she actually was found
trafficking other girls in Mississippi so we pulled her back to have her revoked that hearing just happened this
morning so fresh news she just got a 10-year sentence here um so we're waiting to actually see
Mississippian might take her back and then I'll prosecute her for that additional crime out there as well so uh
one more quick update from the DA's office thank you
all right I'm super excited about today's presentation um we've had this person here once
before a long time ago and she was amazing and so I know she'll be amazing again today uh Marianne Contreras has practiced
nursing over four decades specializing in the field of trauma emergency and
critical care currently she is the injury and violence prevention manager at JPS Health Network in Fort Worth
Marianne studies trauma Behavior environment and policy to develop Implement and evaluate prevention
strategies and initiatives she enjoys multi-disciplinary Coalition work focusing on prevention and
improving the health and safety for the community she is involved in professional education for trauma Health Care
Providers advocating and educating for proficient patient care and Trauma Centers and within trauma systems
Marianne believes positive Community change is influenced by strengthening individual knowledge promoting community
and provider education fostering coalitions and networks changing organizational practices and influencing
policy and legislation I am pleased to introduce Marianne Contreras
thank you good morning thank you all so much for
allowing me to hang with you it's an honor and it was so cool as people were coming in so many familiar faces with
quite there and quite a few of those coalitions that we partner with um at my institution
um and so I really am thankful um that Felicia reached out and I'm able to be here this morning and share some
of the things that we have been developing in my institution with other community members since the last time I
was here which I cannot remember it was probably about four years ago yes it was yeah something like that so we have like
grown a whole lot so I'm here to talk to you about the intersection of intimate partner violence and human trafficking
and utilizing trauma-informed care I got super excited when I heard you say that when you were talking about the job
opportunities government I've got to remember that because I may just look at that but um anyway trauma-informed care
it's really important I am going to just as I talk to I don't know who all is online on the audience but as well as in
person some of the things that we're going to talk about can be very triggering that's a that's a word that everybody is using right now you do what
you need to do to keep yourself full keep yourself safe and keep yourself
well um during during this present during this presentation there we go okay so um
because I am a nurse I work with a bunch of nurses I'm always required to have objectives so those are our objectives
for this morning and because I don't get paid to do this and I don't
have anything to disclose um I always like a pretty picture that calms me down
um those are my puppies my golden doodles and they are eight months old and I am exhausted but they are some of
the best things that's ever happened to me and so I have no disclosures
um a little bit about my health network so we um if you didn't know and I'm sure you all do we are the county hospital we
are now a level one Trauma Center in Tarrant County Harris Methodist congratulations just became a level one
Trauma Center is where I worked there for a dozen years before I went to um JPS but we've been around a little
bit we serve a lot of different populations insurance no insurance
um Tarrant County or if you're a trauma patient from 19 surrounding counties we're going to take great care of you as
a level one Trauma Center we uh don't send things out we're kind of like a Walmart you can get everything you need
right there so we take really good care of our people and we have a lot of different clinics
that I'll talk to you a little bit about as we go as a Trauma Center
um these are the top mechanisms of emitting trauma injuries so the top
reasons why people that are involved in a trauma a physical trauma get admitted to my hospitals and number one is a fall
now we wouldn't think of that but there's a lot of baby boomers on one of them but baby boomers fall down a lot
but also we have construction workers that fall from hives things like that but only like two percent behind that
the number two slot is filled with motor vehicle and motorcycle crashes the third has climbed up since I've been at JPS a
little more than a dozen years now uh gunshot winds that's huge and we hear that every single day all across our
country um that is the third reason why somebody's admitted to my hospital is a trauma it is the number one reason as a
trauma patient the number one reason for death at my hospital is against that wind autoped who knows what an autoped
is Instagram of course because you guys do all this stuff right so an autoped um is
is when I first got to JPS uh that was like 15 down the list
um we collect a ton of data about why people become a trauma patient because I
want to know why so that we can work on preventing it right so autoped my my
thesis or my my theory excuse me my theory on why people are autopilots is that they're walking like this and
people are driving like this I have no data to prove any of that but it is a big deal it is also one of the most
highest hospital bills you will ever give if you are an auto head in Texas Auto pads our patients are injured in
their head in their chest and in New York it's in their hips and their lower extremities think about the vehicles
that we drive versus the vehicles that they drive um and Tide actually for fifth is
assaults and stabbings in the summertime our stabbing rates go super high it gets
hot and people say of each other I have no data to prove why that's true but the numbers show that it's true so and those
are just some of the things that that I that I also focus on uh with
um with the work that I do in preventing violence and injury now I know you can't read that but I I just quick historical
about four or five years ago we started doing a validated tool to screen people for intimate partner violence and it is
based on normalizing violence how often on a scale of one to five with one being
never and five all the time does your person hit insult threaten or scream at
you physically harm you insult threaten or scream at you on a scale of one to
five a score of ten or more um is positive and so when we started
using this we started finding people and we don't screen people that are come in
for being those things we screen them when they come in as a fall as a motor vehicle crashed as a motorcycle crash
um as if anything that they come in for our goal is to screen every single person now because we know that through
research and a lot of the work that we've been doing is that over half of all people that are involved in intimate
partner violence relationships also experience near fatal strangulation or
non-fatal strangulation we started asking a question about strangulation
and um that was a real hard one to get through our system because
um our nurses are not taught that Physicians are not taught that but when
we started looking at the research and at the data out there we learned that that's really a big thing and the folks
in the va's office know that as well so we asked that question as well and then
as we begin to grow in our process of screening um we started to try to find a validated
screening tool everything in my place as opposed to as JP PS and in healthcare should be science-based right we want to
do we don't want to do something off off the seat of our hands we don't want to fly by the seat of our pants we want to
know what is the science behind it well there were no validated screening tools for human trafficking in healthcare you
guys have a ton of them in law enforcement that have like a lot of questions as an old ER nurse I will tell
you that if you told me I had to ask 60 Questions I would go you have lost your mind I don't have time for that I got 18
other faces to take care of so our Hospital joined with uh Syracuse in New
York uh joined with Hospital Trauma Centers across the United States and began a free almost four-year journey to
develop validate and Implement a quick screening tool for human trafficking in
the healthcare field any one yes to these questions
that are that normalize violence like much like our intimate partner one did
anyone yes is a potential positive for human trafficking which
requires further investigation or further sitting down and chatting with our patients
um and when I say normalize violence the first question is not uncommon for people uh to work uh or to stay in work
situations that are risky or even dangerous because they don't have any other options so you're normalizing
something that could be abnormal so we ask have you ever worked or done things in a place that made you feel scared or
unsafe and um we always train our positions in our nurses you know sometimes if you ask a teenager that
they may answer differently than what an adult so these are adult questions these are not validated in our teams or our
youth but these are really good questions just to get a feel for where people are and to understand where
they're coming from I'm very proud to say that in 2022 we screened Bam
um almost 163 000 people and that's um at entrance Point that's in our
community clinics that's in our urgent care and our emergency department and they were uh 162 515 we screened them
for intimate partner in human trafficking regardless of the reason that they came to our organization of
those we found about 423 that were positive for intimate partner and 122
that were potentially positive for human trafficking and of those 195 accepted
Community uh referrals to community organizations
um and that that looks so small compared to the 423 or 122 but that's almost 200
people that we have that we've never impacted before that initial screening number is at 10
000 from the year before so we're getting better at asking the questions in a more normalized way in a more
trauma-informed way and we're doing a better job I think at referring people to uh where they can get the best of
care and have their needs met in a way that they need have their needs met not
in a way that we as public health people think they need to be met now so when I
talk about um uh trauma-informed care we have to realize what the social determinants of Health are and social determinants of
Health are uh where we work live and play and it's it's your own economic
stability it's what your neighborhood and your physical environment looks like a social determinant of Health can be
your education your access to education um are your access to food or can you
even ACCESS food what does your community safety area look like what does your neighborhood look like and do
you have Access to Health Care what's really interesting about the social determinants of health is that we know
we now know through science that 80 of a person's health and
health related behaviors this is really important 80 of a person's actual
physical health and their health related behaviors is determined by the social
determinants of Health it's not if you get an annual checkup even an eye exam I heard someone talking about earlier it's
not about the vaccines that you get or you don't get it's about where you work you live and you play and what you
actually have access to so we look at this in healthcare we're actually beginning to ask questions uh that that
surround Transportation access to food Access to Health Care access to
education to jobs all kinds of things these are things that cause people not only physically to um to thrive or not
but it causes them uh these are things that impact their ability to make good behavior decisions and and I use the
word Behavior just good choices in life or livable choices in life in 76104
where my hospital is uh that is the lowest life expectancy in the state of
Texas so we do a lot of work in 76104 and if you haven't driven through that area certainly people that live in 76104
don't have near the access to food education safety that I do out
in Parker County so when we look at that uh when you think about social determinants of
health and when we think about so we're now we're gonna we're moving and you figuring out how social determinants of
health impact the way that we work with people and impact the way that people react in the life situations that they
are in and so violence is um usually viewed as an outcome of poor social
determinants of Health there can be Goods to I live in a good social determinants of Health zip code I have great lights I have access to food I
have a park that I can walk my puppies in or they can pull me through one of the other but you know a lot of people
don't have that so social determinants of Health can be good and they can be bad but violence impacts social
determinants of Health that are good and that are bad and repeated violent episodes whether it be through intimate
partner whether it be through experiences within human trafficking um greatly impact people's choices and
what their future will hold is a big cichlid type of experience I will tell
you that when we have patients that come in with gunshot wounds it's often not their first time and we're God bless you and we're
connecting patients that um have experience with community and um
Community gang involvement we're connecting them with some of our Community Partners that help to teach
them and give provide wrap around services for high school diploma for job
opportunities even if they have been been arrested and had a felony we're trying to connect them to get them back
in to society to be able to have a better life for themselves
so consequences of um social determinants of Health Public Health consequences so social
determinants of Health all of those areas that I talked about earlier impact the way our children's brains develop as
they grow up their perceptions of what is fried what is wrong what they have
access to their hope their lived experience and so
um social determinants of health impact the brain development it impacts physical being it impacts our mental
perspective it also impacts our financial ability or our financial disability but what is most interesting
to me when I've been studying this is that social determinants of Health almost can be predictive and
generational you know you have families that have uh not access to the to what I have what I
as a privileged person when I have access to and that becomes very generational and it becomes a set
pattern but we know that and I'm going to talk about this in a second we know that our brains can be re-patterned we
can re-work the way our brains think perceive and react to things so many of
the people that you interact with and many of the people that I interact with are in a survival mode they're in a
survival mode to do just that survived people that's instinctual
um and we know that repeated exposure to violence poverty to other systemic
social placements put people in a survival mode so we have to think like that you know um when I go in and talk
with our residents both nursing residents and physician residents and I talk about survival mode they're like Marianne you know we tell them what they
need to do and I'm like they're in a survival mode they know what they need
to do because they're here still they have survived right so uh we need to
come connect with people while they're in this mode and meet them where they are and speak their language and I'm
going to talk about that in just a second but what survival mode does to
people that have had repeated exposure to violence uh repeated exposure to
Injustice um survival mode causes people to have a very reactionary emotions they have
difficulty with in their own relationships with people that they love even and so we need to help people and
understand where they're coming from and where they can go in order to do that
but work with me here for just a second and I have a story to tell you um so in order to tell you the story I
have to tell you a little bit about brain science as we begin this work at JPS of
screening for intimate partner then strangulation and then human trafficking I would begin to delve into things
because the Physicians of the nurses are like why don't they just leave why can't they just sleep whether they're in a
gang why can't they just get out of the game or they're being trafficked or they're in a relationship that they keep going back to and abused repetitive over
and over and so we started digging into the Neuroscience of it it's not necessarily
a logic it's not necessarily a front thinking thought I'm gonna go back I'm going to go back that's not it so let me
tell you about a couple of parts of your brain the prefrontal cortex is right here this is the part of your brain that tells that when I look when I'm crossing
the street and I'm not doing this that in my brain I'm going I gotta look both ways before I cross the street I can
think cognitively I can make really good decisions or I can make bad ones but I'm aware of them
um it causes me to be able to make good decisions my prefrontal cortex is my
personality um and it can help me to determine what's good for me and what's not good
for me now the next one that piece of your brain that we call a dinosaur brain this
is a really interesting piece and it's been around ever since we have it will never evolve away it is what kept the
caveman away from that saber-toothed tiger um it's when he saw the saber-toothed
tiger his prefrontal cortex shut down in the amygdala which is in the center part of your brain takes over it's when that
hair on the back of your neck pops up when you get that creepy feeling something is happening that's your
amygdala don't discount it listen to it it is it's going to save your life one
way or the other um and it processes things around sensory information it's your amygdala
is processing things around and your amygdala is telling your brain something's up we got to get out we got
to go we have to do something something's about to happen it initiates a response of fear and your amygdala is
um it as I mentioned before it kind of hides that frontal section of your brain
so oftentimes when people have that amygdala response have that pre that
dinosaur brain response they get very tunnel Visions a lot of physical things actually happen in your
body your vision goes inward your pupils dilate your uh their blood is shunted to
your arms and to your legs because that helps you to run right and get away so
there are physical things that happen that we will never evolve out of and thank goodness that we won't but it
helps us to be able to take a stand to save ourselves in a very dangerous situation
the other part of the brain that we have no control over this is the third one this is the the last one that I'm going
to tell you is your hippocampus and your hippocampus is this funny little part of your brain in the middle that helps you
to make memories so when people who have experienced trauma when they have been assaulted and
then you go and talk to them and they're like okay so at nine o'clock I was doing this and then oh wait the three hours
are uh sometimes I don't know earlier this was happening but then yesterday and they and so their hippocampus which
normally captures time sequence memories when your amygdala kicks in your
hippocampus kicks in it cannot take those pictures and it had a disruptive
memory people don't speak in a timeline they go back and forth and all over the
place I'll tell you at my hospital when people come in and are like that a lot of
Health Care Providers nurses and Physicians alike think that that is substance alcohol or
behavioral related and they don't give the consideration that it could be a life situation
related says experience to trauma to violence and to control
so um the amygdala I mean the hippocampus during strangulation when there is a
lack of oxygen being supplied to the brain it totally shuts off so the hippocampus is like a camera but when
you don't have the oxygen or when you're in fight flight mode it doesn't have the film inside that
camera to take that picture to make that memory in a Time sequence mode so these
are three things that we actually have no control over we cannot control them so these these
three primitive physical mechanisms that are in our brain are associated with an
unconscious sorry went the wrong way there you go that are associated with an
unconscious response to a chronic toxic and acute
stress physical or emotional threats so these
mechanisms are hardwired they ensure human survivability so we're glad they're there but
understanding what it causes us to do or the people that you're helping or caring
for understanding why they react the way they react it's really important to
understand that to do your best job when you're working with people that have been impacted by violence and
um yeah by violence in general um so this is just when when this happens repeatedly such
as an intimate partner violence relationships in controlling behaviors with uh human trafficking it creates a
chronic stress response we hear a lot about them you know chronic stress chronic stress people get forgetful they
don't know what to do how to um they have difficulty functioning with everyday activities of life because it's
chronic stress because that amygdala has taken over it causes a lot of what we call knee
reactions but it has to do with um with those responses from those three areas
in the brain and the neurochemistry so I'm going to give you a story because I always learn better when there is a
story and this isn't a story this is a true story this is a case study of Allison obviously not her name
um Allison but uh and this initially she came to our facility she was initially seen at
an outside Hospital uh she uh the va's office gave me a call and I said we have
a person sitting here in our office who was strangled to the point of unconsciousness that she had been in an
intimate partner violence relationship which we all know is about power and control human trafficking power and
control there's so many similar victimologies um and uh she'd been seen in an outside
hospital but they hadn't really done any exams on her neck um medical exams she had been repeatedly
strangled to the point of unconsciousness um and that is really important and so why is that important we know that you
have um you see the structure of the neck under underneath the Skin So on the outside you've got the jugular veins
which are blue on both sides they've got we have matching sets um right underneath the jugular veins of the carotid arteries and those are in
red the veins take the deoxygenated blood from the head back into the body
to be re-oxygenated the arteries carry the oxygenated blood up into the head so
all the brain cells can get all the oxygen that it needs our brain is super oxygen sensitive and it has to have it
or we won't survive so when Allison was strangled multiple times to the point of unconsciousness that tells me there was
a significant amount of pressure what you see on the on your right hand side is to occlude or to shut off the jugular
vein it's about four and a half pounds per square inch it's about five to ten pounds per square inch for the Carotid
artery you see a trigger on a handgun is about six pounds per square inch and an average man's handshake is 120 pounds
per square inch it's important to know that because most of our patients when they come in and we ask them the
strangulation question they're like it's okay I just got choked out for a couple
of minutes I'm okay and in that moment they are okay but they got choked out and when every time somebody gets
strangled brain tissue dies which causes traumatic brain injury so this is what
happened to Allison she got choked out several times and that wasn't the first time it had happened but it was the
first time that she reported it this is a picture not of Allison but of
someone that's what it looks like but only looks like that about half of the time
people who have experienced non-fatal strangulation or even fatal strangulation about half of him have no
marks on their neck whatsoever zero so when somebody tells me that
they've been choked down I believe them so we've had to educate our our docs and our nurses because they'll write down
says that they were choked out but their neck looks great well we have to do more exams we have to
do a CAT scan things like that but what Allison told me when she was getting choked out she said um
she's sitting in my office because this was after we had seen her and clear her medically then she came into my office
and we were sitting there talking or she was talking and I was listening and she said I really thought I was going to die
that is what most people say when they've been choked out about 95 I thought I was going to die well what
were you thinking thought I was going to die and then they often follow that with and I was thinking about my kids or my
mom for my dad they think about the people that love them so we screened her we did some CTS of
her we cleared her medically as I mentioned and what she then what she told me after she was telling me about
that very vulnerable very personal thing that happened to her and she was just laying it all out there
she goes and I she was crying and she said I'm so stupid
concept what and she said I'm so stupid I still love him and she was
yes she goes I still love him and I just listened to her so remember that I still love him so
back to the science piece um we all have and and we're teaching this in our hospital as well now
um unconscious or implicit bias this is when we're growing up in our in our social determinants of Health neighborhood whether it's good or bad or
somewhere in the middle we all grow up and our brains are formed by our surroundings by our people and we're
we're informed and our brains developed by what we're learning from others so I can be
um I so they can be positive or it can be negative um are implicit bias and implicit bias
again is unconscious it's um it shapes our own behavior because our
brains are finding patterns in what we've been told the grass is green the grass is green well I'm always going to believe the grass is green until I go
somewhere and it's not green even even if it's not green I'm going to say there's something wrong with that because I know the grass is green
but that's really simplistic um I took a social I took a implicit bias test and apparently I've always
thought myself as pretty I Am Woman hear me roar kind of a person apparently implicit bias I took this test through
Harvard and um it's a really quick online computer test that is a validated tool used to
assess what your own biases were and apparently I think that women should stay home and take care of their
children and men should go to work and provide for their families so I was like me
I'm working right so I have to recognize that apparently that's somewhere in the
back of my head and then I started thinking well okay if I really think that how do I show that I started
thinking about how I'm an old nurse and I thought you know when my cat and I've told this people when my kids were little I worked nights so I could stay
home and raise my children so how judgy am I there right but I had
to recognize that and so think about things in your life and how you've been raised and how you may not consciously
judge people but I now that I know that I can work on changing that
so implicit bias is really important when we're working with people that have made different life decisions based on
their environment based on social determinants of Health based on the people that raise them so it it in order
to understand how to change that my thoughts about that about
women need to stay home and men need to go to work um I had to recognize it so I've
recognized it now I'm working on changing it right I'm working on wait a minute this is great your kid goes to
this school this is wonderful what a great opportunity for him to have experience or her to have experience with other children
um and that kind of stuff so it is a lifelong process to change what started
for me at this age right um we know that our biases can be
malleable and they can change and that's what's really encouraging that we can change our patterns and our brain so
remember Allison I'm so stupid I still love him
so um so when we when I talked to Allison and she had her sister there with her
good support right um she told me that um she told me about this strangulation she
told me about how she was pregnant with her first child uh or with a child excuse me she was pregnant with a child
and um you know she was excited about this child and she still loved him and she
really wanted her family and I didn't go and I'm not saying rah-rah me I just
listened the point being listen and you know this in working with these and working with people that have had
trauma in their lives we have to listen without judgment we have because what does that do that builds that trust
um she told me a lot of things that I'm sure she hadn't told a lot of people
um and and I was trying to be very accepting but the most important thing was that I gave her her space
so that she was safe we hear that a lot nowadays safe space
um but she knew that I was just going to listen and I wasn't going to ask her details and I didn't want to you know
try to dig in what's the whole story kind of a thing um but when you do that
patients and people respond because we all are looking for acceptance and we're
all looking for that love so trauma-informed care is it is informed by social determinants
of Health it's informed by our own implicit bias trauma-informed care is
the way that we treat people right it's creating a safe space for people to talk the biggest thing is one of the biggest
things is that trusting area that whether it's you sitting across for them on the phone with them
you know on a zoom with them anything you're creating a space for them to make
their own decisions for for people to be in control of their own lives because even if they're in Survival Mode they
are surviving right um it the biggest hardest part is just the listening and not jumping in to fix
everything
it involves again and I have this separated in a different type of a chart but it's it's safety it's Choice and
then you work together and collaborate with through trusting and giving them
their power back because we all know that's been taken away um it helps with in my work it helps us
to create a safety plan uh see I said us not me I'm not going to make it we ask what's the most important thing for you
my kids okay let's start with your kids you know it's not in the back of my head I'm like oh my God you better get out
you got to get out but I don't say that because the most important thing to that person are their kids so we're going to
start with the kids and we're going to give them the power to make those decisions because we know when someone
owns their own decisions they're much more likely to become successful at what
they want to do so
um yeah yeah I just said all that okay so the last science piece and keep remembering about I'm so stupid I still
love him okay so this this part here where'd it go
there we go I love the dozen red flags um red flags right
um so so this is the other sciency part that is is my very very very favorite
part because this this is so empowering so when she sat
there and she said I'm so stupid I still love him I said can I tell you something about science
and your brain she goes she was she was very she was crying she was and her sister was there
and it was a big it was exhausting physically emotionally
and I said um okay let me tell you something in your brain
when you first fall in love with somebody when you first have a baby you have these neural hormones that are
dumped there's no on off switch that I can turn them on that I can turn them off and one of those hormones that's dumped
is called oxytocin when I first was in nursing school in 19
a long time ago I learned about oxytocin because back then it was all about natural childbirth don't do it okay
natural childbirth um and bonding with your child as soon as they're born they put that child in
your arms and you've got to look at them and you bond with them well you do and how do you bond with them when you when you first see something a child that you
know that you've been waiting for and you instantly fall in love with in your brain you get this giant dump of
oxytocin so this is this neuro hormone it cause it causes a physical bonding
your pupils dilate you uh you your this oxytocin is dumped
in your brain and it is beginning as it is dumping in to create neural Pathways if every time you see that baby you get
that same feeling again if any mom is ever nursed in here you see that baby and you gotta go nurse the baby because
here comes the milk right you're bonding with this child now the same thing happens when you fall in love with
somebody you meet this person it's usually the first date or the first time together
whether it's intimate partner or being recruited and honeymoon for trafficking it is usually a good thing let me help
you your family doesn't like you I I'm in the CPS system sorry if I'm walking out of the camera
um you're in the CPS system you want somebody to love you and when somebody loves you
that oxytocin starts and it's creating these neural Pathways this is my person
I'm bonding with my person and as that relationship develops it becomes stronger and stronger and that is your
person that is your baby that is your husband that is your wife that is your mother that is your brother that is your
caretaker that person is going to take care of you you don't have any control over that done the second hormone that
is dumped in is dopamine dopamine we have learned in medicine with people
that are chemically dependent have substance use disorder that the first time they take a hit off of a particular
off of a substance they have dopamine receptors in their brain and these dopamine receptors start dumping
dopamine dopamine causes cravings it is not a a weakened sense of self
because I'm weak I can't resist it it is a physical craving that occurs because
this hormone is dumped into your brain so you begin to date this person or this person becomes your dad or your mom and
is taking good care of you and all the the oxytocin and then the dopamine the
craving and after a few months everything is like man this is my person I crave this person I have bonded with
this person this is why I can't leave this is why I can't go or why I keep coming back
and so this happens and so when Allison told me I am so stupid I still love him and then
I told her about those faucets that we cannot turn on or turn off and those
neural Pathways that have been created by those chemicals in her brain that she has no control over
her face changed
she was like not stupid I'm like no you're not stupid
your body's doing what it does and her face it was like her shoulders
went down she breathed so remember that
Okay so telling patience for people sorry I use patience because
that's you know the nurse telling people who have been used and abused because of where they
live because of how they grew up because of their uh people's implicit bias because of their
extenuating social circumstances disabilities abilities
telling people why why they react the way they do because of those three primitive Parts in your brain because of
the chemicals that are dumped in gives them an incredible empowering tool to use
because when I told her that and I said now you know about your brain
you it's a lot of work but you can create different Pathways now
and it's going to take some time and you may go back and you may go forward and you may go back and you may go forward
but there's a possibility and you're not stupid you're extremely brilliant so we focus a lot on biology when we
Empower our patients and we okay perfect I'm about done thank you sorry when we Empower our patients and we Empower our
people that we work with it is a huge um a huge thing and
yes so results so what happened with Allison
so she who in the past have never been willing to talk to anybody began to
um she said yes I'm going to talk to somebody so we referred her to Safe Haven she screamed a 32 out of 37 on The
Jackie Campbell legality screening she got referred and accepted into the high-risk team in Tarrant County
her husband uh she got a protective order she um her father texted me
yesterday she's no longer married um and he is being held accountable and
her physical and her mental uh began and she got family support
um so that was very very very important um
I still communicate she had a void I still communicate with her she's living in an apartment
through all of these different organizations
she has a bed she doesn't have to have table and chairs yet she's working she's going to school and she's raising her
child and she has family support so when I got invited to come here I was very excited
because there's so many different groups here to tell you how what we're doing has in and what we're learning and
growing because it's not just one solution right it's many many things that cause people to survive in the way
that they choose to survive or the way that they learned how to survive
um yeah so these are some of the resources that we use in our own institution now
we actually have victims Advocates that are 24 7 that go throughout the hospital when we round on patients and discover
that patients are victims of violence for all kinds of violence as well as we
have domestic violence forensic nurses who work with those as well now we call Unbound when we have
um someone that we think could potentially be profit because you guys are the ones that do this all the time
and we're just learning about it in healthcare um but what we what we know what we're
doing and if you were here four years ago you saw this slide because this is one of my favorites is it really we're
planting a seed and we plant the seed to build the trust in that trauma-informed
manner to give the power back to that person who has who has their own lived
experience um it's not to rescue or to pull out it's to plant that seed and we tell
people when we talk to them and if they choose like we only had almost 200 referral people that were accepted
referrals we let them know every time you come we're going to ask you these questions because we care about you
and that's beginning with that trust again my favorite quote of all times and
you do the best you can until you know better and then when you know better you do
better so I hope some of that neuro piece is helpful when you work with your people
and do you guys have any questions I made it just in time
questions comments things that you I didn't cover that you
had a question on or investigation thank you
you all do amazing work um I am in awe of the work that you do with your hearts
you have to take care of them as well okay I didn't have the imploding but I
was scared though thank you so much
um that was just
so if any questions come to your mind later and you're like oh I wish I would have asked that just reach out to me and
I will get you in contact with her and we'll get you an answer thank you for coming out this month and we will see
you again in a month