Why are we talking about trauma-informed approaches?

A high number of people living and working in Surrey and north east Hampshire, will have experienced trauma personally or support somebody who has. Sadly, trauma is very common. The World Health Organisation estimates that 70% of adults will experience trauma in their lifetime, but some groups of people are even more likely to experience trauma, for example;

  • people affected by inequality
  • people who access mental health and public services 
  • health and social care staff and emergency services personnel may be exposed to trauma through their job
  • Without realising, current health and social care services can (re)traumatise people who are accessing them for support

What is trauma?

There are many definitions of trauma, but generally we mean experiences (could be a single event, multiple events or a series) that are highly threatening, distressing and overwhelming.

While many people who experience distressing events are only briefly impacted and may not even consider them traumatic, others experience negative effects including post-traumatic stress disorder (PTSD) long after the event, or events, happened.

The severity of this impact can vary from person to person but can impact on every aspect of their life from their relationships, how they feel about the world and themselves, work, sleep and physical health.

For example, did you know: Trauma is a risk factor for nearly all mental health difficulties and diagnoses and problematic substance use

  • People with PTSD are more likely to experience health problems including arthritis, heart-related problems and disease, respiratory system-related problems and disease, digestive problems, reproductive system-related problems, diabetes and pain[1]
  • Women with severe PTSD were found to have twice the risk of ovarian cancer as women with no trauma exposure[2]
If you would like to know more about the impact of trauma, come to our training.

 

 

What is a trauma-informed approach?

A Trauma-informed approach (TIA) is a strengths-based way of working that helps us recognise and respond sensitively to trauma. Given the prevalence of trauma, it assumes that the people we work with and people who access services or are in a caring role are likely to have experienced trauma.  

A Trauma-informed approach aims to understand why someone might be responding in the ways they are by moving to ask: “What has happened to you?” rather than “What is wrong with you?” Its focus is to address the barriers that people affected by trauma can experience when accessing any service (including, health and social care, education, criminal justice system, public services). These all contribute to and impact people’s recovery from trauma.

A Trauma-informed approach involves everyone and is everyone’s responsibility. Services that are trauma-informed, consider every process from the buildings and decor, to how they communicate, to their processes and how they support people to how we might transfer someone from one service to another. A key part of being trauma-informed is coproduction: involving people with relevant lived experience at every step of our processes and decision-making.

Trauma does not discriminate and can affect anyone, so we all have a duty to know about the ways it can affect people. There are different models of TIA, but SAMHSA is one that is internationally recognised. We have adapted their model to better fit the needs of people living and working in Surrey and north east Hampshire, to help implement a TIA. There are 6 principles underpinning a TIA: safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, voice and choice and intersectionality.

Why is trauma-informed care helpful?

Although there are challenges in measuring the benefits of trauma-informed approaches, there is a growing body of evidence that its effects can be wide-ranging, substantial, long-lasting and cost-saving.

Improved outcomes for people using services:

  • People are approached through a “what’s happened to you?” rather than “what’s wrong with you?” lens, where their behaviour is understood in the context of trauma, resulting in greater trust and sense of safety.
  • Coproduction which increases engagement.
  • People are offered more choice and control, making services less triggering via a more welcoming atmosphere (Hopper, 2010), improving engagement and treatment adherence, reduced trauma symptoms, drug use severity and mental health symptoms (Moses, 2003).
  • People are more likely to engage with services (Fallot, 2009; Moses, 2003) increasing the likelihood of the right early help (The King's Fund, 2019).
  • Peer support can help people feel less isolated and can encourage people to access services, improving health outcomes, and reducing the risk that some will not receive the support they need.
  • Services will be improved for example, greater joined-up care, trauma-related problems identified and treated earlier, less “bouncing around the system”, less falling through the gaps in services, fewer frequent attendees, fewer misdiagnoses, symptoms not treated in isolation) so people receive the right support when they do access services.
  • Reduced likelihood of re-traumatisation or further trauma such as people having to retell their story fewer times (Levine, 2010), reduced restraints and seclusions (Azeem, 2011).
  • Reduced inequitable care for people who are under-represented in services or who may have received harmful treatment by services in the past.

Improved workforce outcomes:

  • Improved staff satisfaction (Hales T. W., 2017) and well-being (Bailey, 2020).
  • Improved clinical outcomes and therefore more cost-effective (Domino, 2005).
  • Reduced staff burnout and vicarious trauma (SAMSHA, 2014; Brooks, 2019; National Child Traumatic Stress Network, 2011).
  • Reduced staff sick days/increases presenteeism (LeBel, 2005).
  • More collaboration within (Hales T. W., 2019) and outside their agencies (Hopper, 2010).