More than 250 people packed into the Pearl Stable on Wednesday night for a conversation about how high levels of stress during childhood can lead to physical and mental health complications later in life.

The San Antonio Metropolitan Health District, in partnership with the Rivard Report, hosted a panel conversation and screening of Resilience: The Biology of Stress and the Science of Hope, a documentary that investigates the brain science of adverse childhood experiences (ACEs), such as physical or emotional abuse, food insecurity, and parental incarceration.

Colleen Bridger, assistant city manager and former director of Metro Health, told the gathering that when a child experiences consistent stress, the brain’s fight-or-flight stress response is repeatedly activated, disrupting the development of the brain and other organs and increasing the risk for stress-related diseases and cognitive impairment.

Bridger and fellow panelist Kathy Fletcher, president and CEO of Voices for Children, an advocacy group focused on improving the quality of early childhood care and education in San Antonio and Texas, are chairs of the Trauma-Informed Care Consortium, a collaborative effort to address the impact of trauma on children. The consortium, which formed last August, is working to develop a standardized screening for childhood trauma and a plan to connect families with helpful resources.

The Consortium includes 158 organizations and over 300 community members, many of whom attended the event.

“ACEs are linked to health problems including depression, anxiety, chronic health conditions. This is [information] we have been aware of for decades now,” Bridger said. “We keep trying to solve for chronic disease by treating it [when diagnosed], but public health is about finding the root cause of disease and trying to prevent them.”

It is estimated that at least one in seven children have experienced child abuse or neglect within the past year, according to the Centers for Disease Control and Prevention. In San Antonio, an estimated 15 percent of children have experienced at least four adverse childhood experiences, Bridger said. More than 20 percent of children in San Antonio have experienced two or more ACEs.

“These children’s brains are developing around the belief that the world is a dangerous place to be feared, and we want them to see that there are a tremendous number of people in their community who are able and willing to provide the safe, stable and nurturing environment they need to change that world view and help them heal from their trauma,” Bridger said.

Panelist Father Jimmy Drennan, pastor at St. Margaret Mary’s Catholic Church, said that advocating for children can be as simple as showing up and letting them know that you care.

“For some children, like those showing up in migrant caravans and arriving in San Antonio from other countries, we cannot even imagine the stress and trauma they have experienced, and in some ways, we don’t have to,” he said. “We just have to make sure we are listening without judgment to people telling their stories, and helping them get through it, whether that is connecting them to resources or simply listening.”

Asked how the City and partner organizations plan to address issues such as domestic violence and child neglect, Bridger said the consortium is looking at whether screening for ACEs in children should be universal or more discretionary.

“We are still figuring out the best way to flag [children experiencing high levels of stress and adversity] so we can connect them to the help they need,” she said.

Drennan said that San Antonio already has the capability to address ACEs, including organizations committed to domestic violence, developing parenting skills, and healthy living.

“We need to get the word out more about programs that are available and help people actually get there,” he said. “We need to make sure people understand how they can access free help.”

All three panelists stressed the importance of taking into consideration a child’s possible exposure to trauma when dealing with him or her in school or other settings.

“Trauma-informed care asks that people consider another’s lived experiences and how they might influence how the person responds in a given situation,” Fletcher said. “Behavior cannot be categorized as good or bad, because so much goes into why a child is acting how they are. It’s not for no reason.”

The screening of Resilience: The Biology of Stress and the Science of Hope, closed out a month designated by Metro Health as trauma-informed care awareness month.

“We need people to understand the impact they can have on the life of a struggling child by simply asking, ‘What happened to you?’ instead of ‘What’s wrong with you?’,” Bridger said.

Roseanna Garza reports on health and bioscience for the San Antonio Report.