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Most people may not recognize that stress has become a major risk for a wide variety of health and mental health problems, although when surveyed most people talk passionately about the stress they confront at work. Nowhere is that more true than in human services. It is impossible to understand the full impact of the last thirty years of changes in human service delivery without understanding the impact of acute and chronic stress on workers at every level of the system. This chapter reviews what is known so far about the magnitude of stress impacting daily existence with a specific focus on workplace stressors. The issue of workplace stress is a public health problem of enormous proportion, not dissimilar to what existed two hundred years ago before we understood that microbes cause disease, only now the infectious agent is violence in all of its forms.

This chapter focuses on public health in Wales and the context within which it is delivered. As a devolved service, health policy and the wider public policy legislative framework are the responsibility of the devolved Welsh Government tasked under the Government of Wales Act 2006 with developing and implementing policy, exercising executive functions, and making subordinate legislation. The chapter outlines the organisations involved and the context of the policy in Wales. It also explores the political drive for more collaboration between different organisations as a mechanism for the delivery of better services. The chapter then examines a unique piece of legislation in Wales, the Well-Being of Future Generations Act 2015 (WFG Act), and identifies how this may influence the work of local authorities and other organisations in relation to health and its social determinants. It draws on the available evidence on how this is working so far and looks at two key policy areas jointly driven by the Cymru Well Wales partnership: 'Adverse Childhood Experiences' and 'The first 1,000 days'.

Drawing on qualitative interview data with twelve men approaching release from prison, I explore how childhood trauma is at the root of their offending, based on their personal backstories of neglect, abuse, family dysfunction, social deprivation and community adversity. Involvement in criminality is just one of many symptoms of interpersonal trauma and social exclusion. Wounded people with offending behaviour need to learn to feel safe in their own bodies and to regulate their emotions in healthy ways. If they are not assisted to heal, to locate their real, authentic selves underneath their (mal)adaptive coping strategies, to take joy in human relationships and find purpose in the world, further criminality is a virtual certainty. I argue that penal policy and practice must become aware of the impact of Adverse-Childhood Experiences (ACEs) and trauma-responsive as a matter of urgency. Unless and until all the various actors involved in crime prevention, prosecution, punishment and rehabilitation get to grips with the debilitating impact of developmental trauma and the adverse experience of class, little in the way of lasting positive change can be expected of traumatised offenders.

Chapter one provides a chronological account of the evolution of the project. It began in 2008 as a study comparing Italy’s social welfare approach and with the United States’ free market approach, to explore how social polices affect the ecology of childhood in rich nations. It rapidly became the story of an environmental crisis on a global scale. When the great recession struck both countries, the vulnerability of both systems was revealed. Even as politicians seeking to stabilize markets slashed at existing safety nets, neuroscientific research was documenting the lifelong effects of adverse childhood experiences (ACE) on brain development, adult health and well-being. The strains of recession fuelled a populist backlash and nationalistic political leaders in both countries gained control by inflaming anti-immigrant and white nationalist sentiments. The discontents of globalization, including market economics, technological revolution, rising inequality, mass migration, and climate change, were clearly calling into question dominant assumptions about prosperity through limitless growth. The book evolved to document these changes over a ten-year period. Chapter one closes by explaining the rationale for starting at the micro level; examining the small worlds of children provides a foundation for understanding how global forces are affecting the intimate ecologies of childhood.

Chapter nine looks at the children who are particularly vulnerable and who are at increased risk of living in poverty. Some of these children are living outwith the protection of family and community, e.g. looked after children and refugee/asylum-seeking children, which enhances their risk of poverty and lack of support. Other children are bearing inappropriate levels of responsibility and are a hidden population, such as young carers. There is also a proportion of children who experience trauma and adversity in childhood, sometimes called ‘adverse childhood experiences (ACEs) - such as parental mental health issues, domestic abuse or a parent in prison - that put them at particular risk. These adverse circumstances can also make children more likely to experience complex needs in adulthood, such as homelessness, imprisonment, addiction or mental health issues. It is often the case that these particular adversities are confused with poverty, and there is often the assumption that all children living in poverty are exposed to adverse experiences. This chapter shows that, while it is the minority of children who experience additional adversities in childhood, they comprise a group of children in great need of dedicated services and a dedicated policy response.

This chapter explores the void between the social and economic realities of working class parenting and family life and the unrealities of what working class parents and families are expected to achieve. Forays into Adverse Childhood Experiences (ACEs) research and programmatic interventions (Family Nurse Partnership and Troubled Families Programmes) into working class families, show how the responsibilisation of parents, who are being identified as deficient, is increasingly constructed as the solution to addressing the ‘reproduction’ of crime and poverty in legislation, policy and practice.  As is argued in the chapter, poverty informed policies and unconditional, relational family support are approaches to working with families that are required more than ever.