Adverse Childhood Experiences (ACEs) Report UK 2025

A major public health issue with significant financial, personal and societal costs

Adverse Childhood Experiences (ACEs) are traumatic or stressful events occurring before the age of 18, such as abuse, neglect, or household dysfunction. These experiences have profound and lasting effects on health, behaviour, and life outcomes.

This report is the second national analysis of ACEs in the UK produced by My ACE Story, building on the 2023 report, and incorporates over 2000 new survey responses. The report compares these findings with previous results and a nationally representative sample, aiming to understand the prevalence, impact, and root causes of ACEs, and to propose effective strategies for prevention and reduction.

1. Survey Overview and Demographics
Three main surveys underpin the analysis:
2025 Lived Experience Sample: 2049 self-selecting UK adults (Sept 2023–Nov 2025).
2023 Lived Experience Sample: 2000 respondents.
National Sample: 350 respondents designed to be nationally representative.

2. ACE Scores and Prevalence
The report uses the standard 10 ACE screening questions, supplemented by additional questions on bullying, racism, and community violence. Key findings include:
2025 Lived Experience: Median ACE score of 5; 61% had 5–10 ACEs.
2023 Lived Experience: Median ACE score of 4; 48% had 5–10 ACEs.
National Sample: Median ACE score of 2; 24% had 5–10 ACEs.
These results show that self-selecting samples report higher ACEs than the national average, reflecting the voices of those with lived experience.

3. Most Common ACEs
Across all samples, the most prevalent ACEs were:

• Verbal abuse: 81% (2025), 70% (2023), 41% (National)
• Witnessing household violence: 79% (2025), 72% (2023), 45% (National)
• Living with a mentally ill household member: 68% (2025), 63% (2023), 32% (National)
• Physical abuse: 67% (2025), 60% (2023), 42% (National)
• Parental separation/divorce: 58% (2025), 53% (2023), 34% (National)

The data reveal that violence, mental health issues, and family breakdown are the most common adverse experiences for children in the UK.

Those with a high number of ACEs have much higher experiences of unwanted sexual contact; 31%-35% of females and 16%-20% of males in the Lived Experience samples

4. Health Impacts
There is a clear correlation between the number of ACEs and health outcomes:

• More ACEs = More GP/A&E visits annually and more health conditions discussed.
• Leading conditions associated with higher ACEs include anxiety, depression, ADHD, fibromyalgia, PTSD, autism, and chronic fatigue.
• For those with 7–10 ACEs, the median number of GP/A&E annual visits rises to 3, and the number of conditions discussed doubles to 2.6.The report highlights that certain conditions, such as ADHD, fibromyalgia, PTSD, autism and fatigue, become more prevalent as ACE scores rise. GPs are encouraged to screen for ACEs when diagnosing these conditions, as addressing underlying trauma can reduce healthcare utilisation, especially the misdiagnosis of ADHD.

5. Family Instability and ACEs
Parental separation or divorce is a significant risk factor:

• 2025 Lived Experience: Median ACEs = 4 (no separation) vs. 6 (separation).
• 2023 Lived Experience: Median ACEs = 3 (no separation) vs. 5 (separation).
• National Sample: Median ACEs = 1 (no separation) vs. 4 (separation).

Family instability also increases the likelihood of domestic violence, depression, substance abuse and poor care.

6. External ACEs: Bullying, Racism, and Community Violence

• Bullying: 64% (2025), 58% (2023), 45% (National)
• Racism: 15% (2025), 13% (2023), 15% (National)
• Community violence: 27% (2025), 20% (2023), 19% (National)

Bullying is more common among White British respondents, while racism is more prevalent among Other Ethnicities. Males are more likely to experience community violence.

7. Recommendations for Prevention and Reduction

In-depth details of the following interventions are given in the Report.

7.1. Prevention 

• Raise awareness: All new and expectant parents should be informed about ACEs and their effects. Despite the availability of information, parents are not made aware of ACEs by health professionals.
• Behavioural nudges re positive parenting: Use behavioural science to promote the benefits of and encourage positive parenting. 
• Education: Run a neurodevelopment and ACEs curriculum in all secondary schools i.e. future parents.
• Parenting courses: Offer free, evidence-based online parenting courses to all new and expectant parents. 
• Community initiatives: Replicate successful US community resilience programmes in the UK.
• Show the documentary ‘Resilience’ on a major TV channel frequently.
• Hold a mandatory parents’ assembly at primary schools on ACEs. 
• Stable relationships: Use behavioural science to incentivise family stability and support communication and kindness within families.
• Data-driven interventions: Collect and publish local ACE indices to target interventions and resources where they are most needed. 

7.2. Reduction of Effects

• Trauma-informed practices: State agencies should continue to adopt approaches that focus on understanding and mitigating the effects of trauma.
• Screening: Introduce mandatory ACE screening for children and adults at GP level, or at least for those presenting with certain conditions e.g. anxiety, depression, ADHD, PTSD, autism, chronic fatigue. 
• Self-help groups: Support groups for ACE survivors can reduce mental health disorders.
• Support for at-risk children: Increase attachment to independent adults through mentoring programmes.
• Social prescribing: Encourage volunteering and prosocial behaviour as protective factors. 

Examples of successful interventions are also given in the Report.

8. Policy and Systemic Change 
Shift focus from mitigation to prevention: The report calls for a fundamental change in public service systems, which currently focus on dealing with the effects of ACEs at great cost. Prevention, especially through parental and community engagement, is more cost-effective and beneficial for society.
Disrupt systemic barriers: The report notes resistance to moving to prevention due to budget silos and vested interests in the current system. It advocates for cross-sector collaboration and a shared goal of creating a trauma-free society, rather than a trauma-informed one. This forces the focus onto prevention.

9. Conclusion
The report concludes that ACEs are a major public health issue in the UK, with significant financial, personal and societal costs. Family instability, violence, and mental health issues are the most common ACEs, and their effects are seen in increased health problems and state services use.

Prevention should focus on raising awareness, supporting families, and building community resilience. The Report calls for a shift from costly mitigation to prevention, addressing root causes to help individuals and society thrive.

Download the Executive Summary here.