as you hear your child talk, the first thing you need to do is to get some help for your child because a mother who herself is damaged and injured cannot help her child. very good. and, dr. clark, you were talking about different types of scenarios in terms of how parents need to cope with different types of trauma that their children may have experienced. what other types of actions should parents be taking in a different scenario? well the most important thing, as dr. harris pointed out, you listen but you should also believe your child unless the evidence is overwhelmingly to the contrary, which means, as dr. harris points out, you are taking it outside to explore, to get vindication. so, if it's bullying you are talking to the school. you're talking to the teacher. if it's sexual assault, you're bringing in the appropriate authorities to address that.

if it's a family member, you are not keeping it a secret because you're afraid of embarrassing the family. the issue is that the child will suffer long-term consequences, and you too will suffer consequences because you are either, you're a victim yourself based on the past or you're sitting there harboring this piece of information, which is going to have a destructive impact on you. so, those things become very important to your getting the child help, your getting help for yourself, as dr. harris pointed out, and your setting things in motion where you can mobilize resilience by dealing with the issue directly. and, miss cain, you spoke of domestic violence, that you were a victim of domestic violence once upon a time. what do we tell women that are experiencing domestic violence? what should they be doing? well, getting to safety, and that's so easy for us to say,

you know, and it's so hard when you're living with somebody and you depend on them financially or whatever the case may be or it's your husband. but you need to get away because you don't deserve that. i always tell women that is not what you were meant... you're not a punching bag. you're so much more than that, and to get the help. find out what some of the domestic violence shelters are. and one of the most important things that individual can do when they feel like they feel lost and alone and they're just in this all by themselves is seek a peer. peer support is vital. it's invaluable, and it's one of the things that should be utilized not only in community programs, outreach centers, mental health correction, substance abuse, wherever, there are individuals that have trauma, they need a peer. they need a peer when they come into intake, a peer when they're leaving. they need somebody to say, "i understand what you've been through," because for me i had a lot of people sit down

and ask me questions and i'm, like, looking at them like you have no idea. you don't understand anything. so, peers would certainly help in that regard. peer support, peer support, peer support. dr. gillece, in terms of how folks are going to be able to cover some of these services, what does the affordable care act offer in the area of trauma-related services? well, you know, i might have to defer to someone on that because that is really not my area of expertise. so, if someone else would like to answer that, i'd appreciate it. but i would like to just say one thing about what tonier was saying about domestic violence. i think we really can't underestimate the needs of the children who witness domestic violence in the home. so, it's not just the safety for the parent, but to get that treatment. so, i'm going to throw the carrot to you. dr. clark. well, our hope is that the affordable care act will provide opportunities for treatment to victims of trauma, whatever the source of the trauma is.

as you know, the effort of the affordable care act is to make health care available to a wider range of individuals. and because they'll be providing coverage to people with lower incomes, many of whom are the victims of trauma, they'll be able to get assistance from community health centers, providers, community mental health centers, social workers and psychologists, and other providers of care. so, this will provide a mechanism both for adults and for children and adolescents. but i would like to point out that children and adolescents are often eligible for care now through other insurance programs. but the key issue is, if we're not willing to get beyond the secret, having access to reimbursement is irrelevant because nobody's going to show up at the door and, no matter how skilled the clinician is, they can't treat an empty chair. if i could talk for just a minute about domestic violence.

i think that this is really a horror that affects somewhere around 30, 35 percent of women. and, while i absolutely agree with miss cain that it is critical for women to get to safety, no one deserves to be punched or emotionally abused. very, very few women leave the first time. and i think sometimes professionals don't understand that. and they are judgmental and start to think, "what's wrong with her?" maybe she likes that treatment. i just want to be clear: nobody likes it but, as with a lot of terrible dynamics, they're hard to break right away. if they were easy, those of us in the health care business would be out of business. it takes people time, and we need to recognize that and not make women feel bad

if they go back to a violent situation a couple of times before they finally free themselves. very good point. and, dr. clark, let me go back to the whole notion of what samhsa is doing currently. one of our strategic initiatives is on trauma and justice. you want to talk a little bit about that? well, we have eight strategic initiatives at samhsa. one of them is indeed trauma and justice, making it clear that we believe that we have to deal with trauma as an integral part of the behavioral health strategy to assist people in need of services. so the strategic initiative lead is lar quong dr. lar quong, appointed to that role by pamela hyde, the administrator of the substance abuse and mental health services administration, with the focus on working not only with issues of domestic violence but also working with the issues

of the criminal justice system because, indeed, as i mentioned, it's not the abuse excuse, it is trying to break the cycle. we spend a lot of money reincarcerating individuals who have primary issues that have never dealt with, so especially in nonviolent situations. we wanted to break that cycle and, as dr. harris pointed out, we also want to create a workforce that has a stable appreciation of traumatic phenomenon so that, again, we don't blame the child, we don't blame the wife, we don't blame the spouse who is the victim of trauma. and the gains center also has some training programs as well as other initiatives, correct? yes, we have a number of programs that address trauma, and one can access that from our web site at wwww.samhsa.gov gains center. we have a national center on traumatic stress.

we've got the activity that dr. gillece is engaged in, and we've got the activity that miss cain is engaged in. and we've got community programs like dr. harris is engaged in. but the key issue is, while we're not solely responsible for addressing these issues, we are working very aggressively. we also have partnerships with the administration for children and families, the department of defense, the department of justice, and the veterans administration, and hrsa, so that we deal with trauma across the board. we want it to be in primary care settings. we want people asking about it. and then we want to make sure we have a workforce that's skilled enough to begin to do something about it. and we are very glad that you have enlightened our audience related to this topic. i want to remind our audience that national recovery month

is celebrated every september, and we're hoping that you engage and be visible and vocal during this month by hosting events and also be engaged, not only with the family, but with those that are in recovery. i want to thank you for being here, and it was a very good show. thank you. for a copy of this program or other programs in the road to recovery series, call samhsa at 1-800-662-help, or order online at recoverymonth.gov and click multimedia. every september, national recovery month provides an opportunity for communities like yours to raise awareness of substance use and mental health problems to highlight the effectiveness of treatment and that people can and do recover.

in order to help you plan events and activities in commemoration of this years' recovery month observance, the free recovery month kit offers ideas, materials, and tools for planning, organizing, and realizing an event or outreach campaign that matches your goals and resources. to obtain your copy of this year's recovery month kit and gain access to other free publications and materials related to recovery issues, visit the recovery month web site at www.recoverymonth.gov or call 1-800-662-help. [music]

[music] paratransit is specialized transportation for seniors and people with disabilities who are unable to use the muni system. in san francisco, we're proud that we've had a paratransit program since 1978 long before it was mandated by the americans with disabilities act in 1990.

san francisco is a unique city and our paratransit program reflects this. we have a network of services, including sf access van service, paratransit taxi, including wheelchair accessible ramp taxi and group van which serves groups of individuals going to a single location like a senior center. [music] >> i'm elsa scott and i'm a retired federal employee and i'm a native of san francisco. i use paratransit because, i've been using it for about six years because six years ago i had to start dialysis treatments at cpmc. so i'm very dependent on paratransit three times a week, coming and going.. my current driver is brian berquist.; he's just such a friendly, sort of a teddy bear kind of a guy.

i don't know what it is about brian, but all of us old ladies want to feed brian. [music] >> hi, my name is fred lein. i'm most proud of driving a ramp taxi since the beginning of the program in 1994. [music] >> fred, you are the absolute best! thank you fred for providing transportation for me and opening up my social life, and taking care of medical appointments, taking care of my mother [music]

>> hi, my name is ann bailey and i've driven for luxor for almost five years now. i drove for desoto cab for 10 years prior to that. i drove in 1976 for the old, old yellow cab. this is frances mecchi and i've been driving her for about 11 or 12 years to her alzheimer's day program, which we call the memory club. every day when we drive through the presidio she'll say, "oh goody, you're taking me through the enchanted forest." [music] >> my name amr a.mahmoud. i am like 49 years old. i have been driving cab more than 13 year in general.

then i drove a ramp more than 3 years. this is my fourth now. i have been enjoying doing the job. i like every moment of it. >> thank you amr. [music} >> hi, my name is peter and i'm a paratransit driver for medsam, and this is north and south of market where i pick up my group and drop them off at home. >> thank you , peter! [singing] you are my sunshine. very good driver. she says driver is very good. number 1.

[music] larry mingo, mobility plus driver, san francisco paratransit. >> thank you, mingo. >> you're welcome. >> hi, mingo. >> thank you, mingo. >> thank you, mingo. thank you. [music] >> thank you, larry mingo. >> hey larry mingo, you are awesome. thanks for a great, great job you do for us. appreciate it. >> thank you, mingo. [music] >> hello, my name is james fells i've been working with paratransit for 13 years now. i get a kick out of the job; i

like helping people you know when they need help to go shopping or getting picked up at the medical building. i really like helping people and that's why i've been working so long. >> hi, my name is kalani. i'm a driver with mobility plus. i love my job! and i've been working, i've been a driver since may and i'm pretty satisfied with the company. so, two thumbs up, hope you guys have a nice day. >> sandra johnson and i've been working for mobility plus for about 4 and a half years. i love it. this is my job and i love it. it's very rewarding for me. one of my proudest moments is one of my clients left his cane on the bus and i've been picking him up now for about three years so i know that that cane was important to him. and i had dropped him off and i noticed the cane later on that day so i kept it with me and when i went back down to la

play, when i worked my way back down there on a break to give it to him, he kissed my hand, 'cuz he can't talk. so he grabbed my hand and he kissed my hand. it just made me know that that was an important thing for him. so that was my proudest moment. [music] >> one couple who were riding with us, morning and afternoon, mr. and mrs. lee. mr. lee was the dialysis patient and he's probably in his 80's and every time we would drive up to buchanan street, the hospital, mr. lee would say, "good job, fine driver, number one driver" and he would go like this [thumbs up gesture]. and then as brian would be helping him off the van, mr. lee, i heard him so often say, "brian, if anybody gives you any trouble you send them to me and i'll take care of them." and here great big old brian would say, "henry, you're the first one i would try to get help from." and he says, "the second one is

elsa." [laugh] so we knew that we were being relied on by brian. a few weeks back, mrs. lee called brian early in the morning to tell him not to bother picking them up because they were already at the hospital. mr. lee was ill and she had taken him to the er. the next day or so, brian, on his lunchtime, found out that mr. lee had been admitted to the hospital and he went up to mr. lee's room and just stuck his head in just to say hello. and the minute mr. lee saw him he went [gesture thumb up in the air] like that. and mrs. lee said, "he's telling you again you're number one driver. so brian really appreciated that; he thought that was really sweet. but he could see mr. lee wasn't doing so well so he left really quickly. and unfortunately, mr. lee passed away that evening. that had a great impact on brian and me.

it was very sad, but it was so touching that he had seen mr. lee and mr. lee had confirmed that brian was "number one driver." >> this is san francisco paratransit. it's not perfect; we have our ups and downs: late trips, frustrated customers, stressed out drivers. but at our best, we get our riders where they need to go on time and with a smile. and when we pay attention real carefully and notice what's happening on the van, taxi, or at the senior center, we notice that our drivers make a difference in the rider's lives and the riders make a difference in the drivers lives.