Trauma History and Extensive Service Use: Strategies for Treatment and Prevention


  • Introduction:  David Shern, PhD, Senior Public Health Advisor, NASMHPD
  • Maggie Bennington-Davis, M.D., Chief Medical Officer, Oregon Health Share 
  • David Labby, MD, PhD, Health Strategy Advisor

As part of an effort to understand the root causes of heavy service utilization and poor outcomes, Health Share of Oregon, one of the state’s coordinated care organizations, undertook a careful retrospective evaluation of the life course experiences of approximately 50 individuals with a pattern of heavy service use.  They found that these individuals had extensive trauma histories throughout their life course.  Oregon Health Share subsequently designed and implemented trauma informed approaches to more successfully engage and serve these individuals across settings.  Additionally, they have launched community level interventions to reduce exposure to trauma and strengthen resilience for the Medicaid population they serve as an accountable care organization.  There are now nearly 4,000 Medicaid members in the Life Course study. Dr. Bennington-Davis and Dr. Labby will discuss this work and its application to a trauma informed framework for prevention and treatment planning.