Justice Advocate Ashley Biden Touts Role of Trauma Support Pioneered in SF

Ashley Biden, the president’s daughter and a social worker, visited San Francisco this week to advocate for trauma recovery centers (TRCs) — a model that was created in the city.

“Think of it like a one-stop shop for mental health,” said Biden during a visit Wednesday to UCSF Citywide, a psychiatric facility in San Francisco’s South of Market neighborhood. “So we are going into the community to find those who have been victims and to ask them if they want to receive services to come into the TRC.”

UCSF pioneered the TRC model in part to support victims of crime living in communities of color, offering comprehensive case management, from meeting people’s basic needs to specialized psychiatric services.

Biden, who is also a consultant for the National Alliance of Trauma Recovery Centers, said TRCs could be a solution for many states as the U.S. continues to face a mental health crisis, made worse by the COVID-19 pandemic. Just this week, the Biden administration announced millions of dollars in grants — adding to the billions allocated toward addressing the issue.

“Dad is dedicated,” Biden said. “We're going to have some real issues if we don't win the House and Senate. I mean, it's over, right? It's over in the sense of what's to come. Our rights. Mental health care. All of it.”

Biden talked with KQED morning host Brian Watt. Here’s an excerpt of their conversation, which has been edited for brevity and clarity.

BRIAN WATT: You became aware of trauma recovery centers through your work as a social worker. And as the daughter of a public servant and an educator, how did you decide that being a social worker and this type of work was your life's mission?

ASHLEY BIDEN: So I was on many campaigns, in many parades and many door knocks. (President Biden) was very grassroots. I would travel with him everywhere and I would always question the inequity. I also went to a Quaker school and learned about racism from a very young age. And it was my mission to tackle structural violence and institutional racism. Why aren't people healing? Why are the most marginalized the most harmed, yet the least healed?

So what do trauma recovery centers do for people who have experienced interpersonal violence in cases of physical and sexual assault, domestic violence and police brutality?

It is person-centered, survivor-centered care where there are evidence-based therapies that we know are effective for treating things like PTSD. I believe about less than one-third of victims who have PTSD right after a violent crime or situation receive some type of treatment. So trauma centers increase access and make it equitable for those who might not be able to receive services in traditional settings.

Is part of the problem that a lot of people who are victims of violence, they just don't know these services are out there, possibly ready to serve them?

It’s a few things. One is when you are a victim of violent crime, you can often develop PTSD, and those symptoms often don't allow for one to receive services. What we know about PTSD is that oftentimes people don't want to leave their houses. It’s hypervigilance. So part of it is the trauma from the actual incident. And honestly, I think the other is not believing that services will work for them.

And it really does depend on access. Historically, if you have money, you can pay for a therapist. You can go and get inpatient treatment for trauma. You can get some of these evidence-based treatment modalities. If you don't have the means, you can't. And we've got to change this — Medicaid. The reimbursement for mental health treatment and trauma treatments is so low.

You participated in a roundtable at UCSF about the role of trauma recovery centers in reimagining public safety. That is a big topic here in the Bay Area and, frankly, nationwide. Tell us more about that.

There is a lot of generational trauma, so what we're trying to do is to break that trauma. We are trying to get somebody at the first point of victimization where we can help them to heal so they don't hurt another person. So they don't retaliate. And if we could actually provide those who need real mental health treatment and we could provide them with effective treatments that work, we're going to be a safer society.

Racism is trauma. Having to be judged your entire life because of the color of your skin is traumatic. And so we really do everything we can to empower, to give people actual skills. When you're triggered, what are you going to do? When you see the guy that you know you want to beat up? How are you going to not beat him up and walk away? How are you going to get your anger under control? And depression?

It's breaking generational trauma. It's also making sure that people have access to the services that they need, that maybe historically they have been marginalized from.