What question changes in trauma-informed mental healthcare?

Details

Trauma-informed approaches emerged partly in response to research showing that trauma is widespread across society, is highly correlated with mental health, and is a costly public health issue. The fundamental shift is from asking “What is wrong with you?” to considering “What happened to you?”

This explanatory article, authored by trauma survivors and service providers, describes trauma-informed approaches to mental healthcare, why they are needed, and how barriers can be overcome to implement them as an organisational change process. It describes how past trauma can be understood as the cause of mental distress for many service users, and how staff who are not trauma-informed can retraumatise service users. Staff can also experience service users’ trauma vicariously and can themselves be traumatised by practices such as restraint and seclusion.

The authors describe opportunities to improve service users’ experiences and staff working environments, increase job satisfaction and reduce stress by improving staff–patient relationships through greater understanding, respect and trust. The learning objectives include appreciating broad-based definitions of trauma; understanding trauma-informed approaches, why they emerged and the potential for trauma or retraumatisation in the mental health system; and considering how to practise these approaches, including in organisations that are not trauma-informed, along with potential barriers and opportunities.

A. S. is funded by a National Institute for Health Research (NIHR) Post-Doctoral Fellowship. The article presents independent research partially funded by the NIHR. The views are the authors’ and not necessarily those of the National Health Service, the NIHR or the Department of Health.