Jonathan Sutton is the CEO of St Paul's Hostel in Worcester, which provides accommodation for homeless people. The former British army officer told the Worcester News about the St Paul's team's pioneering approach, which sees them asking homeless people 'what happened to you?' rather than 'what's wrong with you?'.

There are things we do not often talk about at the dinner table. Childhood abuse, neglect and living in dysfunctional households are particularly difficult topics to talk about there or anywhere else. Nevertheless, the start we get in our early life can have an enormous impact on our health and well-being in later life.

At St Paul’s Hostel, we do a lot of work on what are called Adverse Childhood Experiences (ACEs). These are common across all sorts of families. There are 10 and these include; physical abuse, emotional abuse and sexual abuse, emotional neglect, physical neglect, living with the loss of a parent (who is dead or in prison), witnessing domestic violence or living amongst substance abuse and mental illness.

Just over half of people reading this newspaper will have experienced up to three ACEs. At St Paul’s the average client has had seven but nine is very common and we have found at least one person with 10.

The academic ACE studies are plentiful and evidence for those with multiple ACEs compared to those with none, is stark. Four ACEs can double the risk of heart disease and cancer, five ACEs increases the risk of alcoholism eight times, and six or more ACEs could lead to death 20 years earlier than the average.

This is not just psychological because experiencing these childhood adversities triggers physical responses to what the brain interprets as threats. If prolonged, and accompanied by an absence of meaningful relationships, they affect brain development, maturity and the capacity to learn. It can lead to a person who we might say is wired but not connected, a person who sees the world very differently.

Having learnt about the impact of these traumas, we at St Paul’s have shifted our culture. It has changed our approach from the moment someone walks through the door. At its simplest, we do not ask (or think) “what is wrong with you” but we ask “what happened to you?”

The idea some people have, that homelessness can be, or is, a ‘lifestyle choice’ is far from the reality of my day-to-day experience. By perpetuating the belief that some people choose to quaff skull-numbing high-strength alcohol before breakfast, or gamble with their life with the next shot of heroin, we obscure the reality that they are very often – perhaps always – people who have been damaged by life. It seems to me they are trying to find a way to make the pain of their childhood past, and their shame about it, go away

Poverty – and particularly childhood poverty – grinds away ominously at life chances. Local labour markets, housing supply and social welfare policies contrive to tilt the playing field against people ever changing their very difficult life circumstances. Are we surprised that a typical resident of St Paul’s Hostel did not attend King's or RGS nor did they grow up in Battenhall or Claines?

The antidote to ACEs is positive human connection. Dr Nadine Burke Harris, in her book The Deepest Well, identifies these adversities as ‘toxic stress’ and she demonstrates the long-term consequence on a child’s health, their educational attainment and leads to poorer social outcomes.

Let me tell you about one of our clients at St Paul’s Hostel. She experienced nine ACEs as a child. She struggled at school and ended up living on and off the streets, having stints in prison, and becoming dependent on hard drugs. She never summoned the mental strength or courage to talk about her childhood experience until we gave her the space to feel safe. With counselling and authentic relationships, she was able to come to terms with what happened when she was young. She is now living in her own place and, with continuing support, starting to thrive.

I’d like to invite you to make the same change we have. When you next see a person in the street or a hunched figure at the entrance to St Paul’s Hostel, change the nature of the question you ask. Stop asking ‘what’s wrong with you’ but instead ask ‘what happened to you?’

From this question, a journey of understanding, curiosity, compassion and connection will open up ahead of you.