Understanding ACEs: Why They Matter in Mental Health Care
- Monet Ince-Amara
- 4 days ago
- 3 min read
What Are ACEs?
Adverse Childhood Experiences (ACEs) refer to potentially traumatic events that occur in childhood (before age 18). These experiences include various forms of abuse, neglect, and household dysfunction—such as witnessing domestic violence, living with someone with a substance use disorder, or enduring physical or emotional neglect.
The original ACE study, conducted by the CDC and Kaiser Permanente in the 1990s, revealed a groundbreaking connection between early adversity and later-life health issues. Researchers found that the more ACEs a person experienced, the greater their risk for chronic physical conditions, mental health disorders, and behavioral challenges.
Common Categories of ACEs Include:
Abuse: Physical, emotional, or sexual
Neglect: Physical or emotional
Household challenges: Domestic violence, parental separation or divorce, incarcerated family members, or substance use within the home
Why ACEs Matter in Mental Health Care
ACEs don’t just fade with time. These early-life stressors can alter brain development, hormonal regulation, and immune response, laying the foundation for long-term health complications. Individuals with high ACE scores are more likely to struggle with anxiety, depression, PTSD, substance use, disordered eating, and even suicidal ideation.
From a psychiatric lens, ACEs often explain why some individuals don’t respond to traditional treatments or why symptoms recur despite medication. ACEs shift our focus from "What’s wrong with you?" to "What happened to you?"—a crucial change in perspective for any trauma-informed provider.
The ACE Score: A Tool, Not a Label
The ACE questionnaire is a 10-item screening tool that gives providers a quick way to assess early life adversity. The score ranges from 0 to 10—higher scores reflect greater risk. But it’s not the number alone that matters; it’s the story behind the score.
Why Providers Should Use ACE Screening:
Uncover hidden trauma: Many patients may not disclose their full history unless asked directly and gently.
Inform treatment planning: Understanding trauma roots helps providers tailor interventions, from therapy modalities to medication plans.
Guide prevention and early intervention: Identifying ACEs early can help providers address emerging issues before they evolve into chronic conditions.
Foster trust and empathy: Trauma-informed care builds safety, empowerment, and connection, especially for survivors of early adversity.
Why It’s Vital to Integrate ACEs Into Care
Incorporating ACE awareness into psychiatric and primary care settings improves outcomes across the board. For example:
Patients with high ACE scores benefit from integrative and lifestyle psychiatry, which addresses nervous system regulation, stress response, and healing through sleep, nutrition, movement, and connection.
Supplement protocols like magnesium, omega-3s, and adaptogens may help buffer stress and restore nervous system health in ACE-impacted individuals.
ACE-informed care strengthens cultural humility and trauma sensitivity, especially for communities historically underdiagnosed, misunderstood, or retraumatized by the medical system.
At Mendem, we believe healing begins when patients feel safe, seen, and supported. By acknowledging the unseen wounds of childhood, we help our clients reclaim their story—not as a diagnosis, but as a foundation for healing.
Are you curious about how trauma may be influencing your mental health? At Mendem, we offer compassionate, trauma-informed care rooted in the principles of lifestyle and functional psychiatry. Let’s work together to uncover the root causes of your symptoms and build a plan toward true healing.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8
Understanding how past experiences shape our present well-being is incredibly powerful. The Adverse Childhood Experiences (ACE) study provides a framework for this. If you want to understand your own history better, you can take a confidential ACE Test online.