Assessing adverse childhood experiences among people with mental health problems during community outreach support: A retrospective cohort study

Abstract Background Adverse childhood experiences (ACEs) have lifelong effects on mental health. However, actual situations among users of community comprehensive outreach support with various mental health problems are unclear. The study comprehensively explored community outreach support users’ ACEs, associated factors, and when these experiences are disclosed during the service process. Methods In this retrospective study conducted using service records dating October 1, 2015 to April 30, 2023 from the outreach service in Tokorozawa city, Japan, we collected demographic and clinical characteristics, along with the number and variety of ACEs shared by participants during the six assessment points. Results Of the 143 participants whose data were analyzed, 54.5% had at least one ACE, and ACEs were associated with lower age and receiving public welfare for economic deprivation. Further, the number of assessed ACEs increased until two years after service initiation and then leveled off. Conclusions This study highlights that more than half of community outreach support users have had ACEs; this is particularly true among younger individuals and those facing economic challenges. The findings emphasize the potential need for trauma care in community settings. Service users may need as long as two years to share ACEs with staff, and that assessment of traumatic experiences may be a long-term process that involves engagement building.