Findings from a new national study across Wales found adults who had suffered four or more types of ACE were almost 10 times more likely to have felt suicidal or self-harmed than those who had experienced none. The study by Public Health Wales and Bangor University also found that some basic community measures help build resilience which can help protect individuals from developing the mental health problems that ACEs can cause. Results show that the more ACEs people suffered the greater their risk of mental illness throughout life. Having ever had treatment for a mental illness increased from 23 per cent of those with no ACEs to 64 per cent of those with four or more. For ever having felt suicidal or self-harmed the rise was from 6 per cent to 39 per cent.

Developing resilience through access to a trusted adult in childhood, supportive friends and being engaged in community activities, such as sports, reduced the risks of developing mental illness; even in those who experienced high levels of ACEs. Overall having supportive friends, opportunities for community participation, people to look up to and other sources of resilience in childhood more than halved current mental illness in adults with four or more ACEs from 29 per cent to 14 per cent, and ever having felt suicidal or self-harmed from 39 per cent to 17 per cent.


Participation in sports both as a child and adult was a further source of resilience to mental illness, with being in current treatment for mental illness reducing from 23 per cent in adults that did not regularly participate in sports to 12 per cent in those that did. ACEs are traumatic experiences that occur before the age of 18.  These experiences range from verbal, mental and physical abuse, to being exposed to alcoholism, drug use and domestic violence at home. The Welsh Adverse Childhood Experience (ACE) and Resilience Survey was undertaken to examine individual and community factors that may offer protection from the harmful impacts of ACEs on health, well-being and prosperity across the life course.

Other key findings from the study include:

  • The proportion of people with four or more ACEs reporting current mental illness fell from 37 per cent in those with low overall adult resilience levels to 13 per cent in those with high overall adult resilience levels
  • The proportion of people with four or more ACEs reporting current mental illness fell from 35 per cent in those who felt financially secure for no more than a month to 11 per cent in those who felt financially secure for at least five years

Resilience is described as the ability to overcome serious hardships such as those presented by ACEs. Data were collected between March and June 2017 in face-to-face interviews with a Welsh sample of 2,005 18-69 year olds, and a boost sample of 492 residents in areas with higher levels of Welsh spoken language.

To read the full report and view the corresponding infographics, please visit the Public Health Wales website.