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A paradigm shift: relationships in trauma-informed mental health services

  • Angela Sweeney (a1), Beth Filson (a2), Angela Kennedy (a3), Lucie Collinson (a4) and Steve Gillard (a5)...
Summary

Trauma-informed approaches emerged partly in response to research demonstrating that trauma is widespread across society, that it is highly correlated with mental health and that this is a costly public health issue. The fundamental shift in providing support using a trauma-informed approach is to move from thinking ‘What is wrong with you?’ to considering ‘What happened to you?’. This 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 so that they can be implemented as an organisational change process. It also describes how past trauma can be understood as the cause of mental distress for many service users, how service users can be retraumatised by ‘trauma-uninformed’ staff and how staff can experience vicariously the service user's trauma and can themselves be traumatised by practices such as restraint and seclusion. Trauma-informed mental healthcare offers opportunities to improve service users' experiences, improve working environments for staff, increase job satisfaction and reduce stress levels by improving the relationships between staff and patients through greater understanding, respect and trust.

LEARNING OBJECTIVES

  • Appreciate broad-based definitions of trauma
  • Gain an understanding of what trauma-informed approaches are and why they have emerged, including the potential for (re)traumatisation in the mental health system
  • Consider how to practise trauma-informed approaches, including in ‘trauma-uninformed’ organisations, and the potential barriers to and opportunities from doing so

DECLARATION OF INTEREST

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

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Corresponding author
Correspondence Dr Angela Sweeney, St George's, University of London, Population Health Research Institute, Cranmer Terrace, London SW17 ORE, UK. Email: asweeney@sgul.ac.uk
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A paradigm shift: relationships in trauma-informed mental health services

  • Angela Sweeney (a1), Beth Filson (a2), Angela Kennedy (a3), Lucie Collinson (a4) and Steve Gillard (a5)...
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