Thanks to the work happening under the banner of Building Strong Brains Tennessee (BSBTN), Tennesseans across the three grand divisions are becoming aware of Adverse Childhood Experiences (ACEs) and the impact they can have on the health and well-being of the population. Individuals representing diverse groups across the state, including state government, the private sector and the community are learning about the importance of resilience in mitigating the effects of childhood trauma, and innovators across disciplines are devising strategies to build resilient communities. As Building Strong Brains Tennessee continues to grow in both activity and scope, there has been increased interest in the work both locally and nationally. This document serves as a snapshot, capturing a moment in time, to be used as a reference for anyone wishing to learn more about the work and how Building Strong Brains Tennessee came to be.

Changing the Conversation – From “What is Wrong with You?” to “What Happened to You?”

The future of any society depends on its ability to foster the health and well-being of the next generation. When Tennessee invests wisely in children and families, the next generation will pay that back through a lifetime of productivity and responsible citizenship.

Science tells us many children’s futures are undermined when stress damages early brain architecture. But the good news is that potentially toxic stressors can be made tolerable if children have access to responsive adults – parents and caregivers, home visitors, child care providers, teachers, coaches and mentors – and safe, stable and nurturing environments.

As Tennesseans understand the impact of ACEs, they realize the importance of preventing and mitigating the effects of these experiences whenever possible. They understand the value of supporting children and families when adversity does occur. Better collaboration among sectors and a focus on the infrastructure of services and supports makes a difference. When services and supports – healthcare, child abuse and domestic violence prevention, home visiting, mental health and substance abuse services for parents and a variety of others - are available for early intervention, they put in place a preventive system that improves interactions and relationships before they break down. Sound investments in our society’s future are confirmed by brain science and improve outcomes for children now. They provide a significant foundation for solutions to many of the long-standing challenges we face as a state in health, mental health, social services, child protection and juvenile and criminal justice systems.

All children need someone in their corner. The shift from “What is wrong with you, or why are you a problem?” to “What has happened to you, and how we can we support you and help you overcome these experiences?” will result in a more effective service delivery system. A common understanding and language allows individuals from many sectors to use their collective expertise to address complex social problems at scale resulting in a stronger Tennessee.

Beginning in 2015, a small group of dedicated individuals came together with the shared belief that making that shift should be among the top priorities as a state. Their message found an enthusiastic audience and has spread quickly, and what was a collection of individual efforts has become a movement for cultural change. This is the essence of Building Strong Brains Tennessee.

The strategy for making this cultural shift relies upon a multi-pronged approach: Philosophy and Approach, Policies and Funding, Programs and Services, and Professional Practice – routinely referenced as the four P’s. Comprehensive systems change requires all of these areas be addressed, and of course, each of the four P’s relates directly to the others.


  • Increase the potential that every child born in Tennessee has the opportunity to lead a healthy, productive life.
  • Raise public knowledge about ACEs.
  • Impact public policy in Tennessee to support prevention of ACEs and to reduce community conditions that contribute to them.
  • Support innovative local and state projects that offer fresh thinking and precise measurement of impact in addressing ACEs and toxic stress in children.
  • Seek sustainable funding to ensure the state maintains a long-term commitment to reduce the impact of adverse childhood experiences.
  • Embrace open, responsive governance through statewide planning groups and the Three Branches Institute , comprised of leadership from the Executive, Legislative and Judicial branches of government, who were invited by the Governor to form a common agenda to advance child welfare and realign the juvenile justice system.