A Care Planning Strategy for Traumatic Life Events in Community Mental Health and Inpatient Psychiatry Based on the InterRAI Assessment Instruments

Abstract

Clinical triggers from the Traumatic Life Events Clinical Assessment Protocol (CAP) identify individuals who might benefit from formal services or additional supports targeted towards trauma treatment. The Traumatic Life Events CAP identifies two groups who have experienced one or more potentially traumatic life events: (1) those who are in immediate danger due to current abuse/criminal victimization; (2) those who have experienced one or more traumatic events that evoked an intense sense of horror or fear. Descriptive analysis was conducted across psychiatric hospital and community-based mental health service settings to compare the two triggered groups to those without traumatic experiences (the not-triggered group). The Traumatic Life Events CAP identified subpopulations with unrecognized and untreated traumatic-stress-related symptoms, which are of great concern for those in community-based mental health services who are in immediate danger due to current abuse.

Beyond the ‘Iron Lungs of Gerontology’: Using Evidence to Shape the Future of Nursing Homes in Canada

“…Through a multinational research effort (Fries, Morris, Bernabei, Finne-Soveri, & Hirdes, 2006 ;Mathias, Hirdes, & Pittman, 2010 ;Morris et al, 2008 ), the CAPs were recently refi ned to update triggering algorithms for initiation of care planning and to link the recommendations for intervention in the target areas to current international practice guidelines. These protocols, providing standardized, empirically based methodologies for the development of person-centred care plans, are now available for the majority of Canada's nursing home residents and home care clients.…”

Using Routinely Collected Clinical Assessments in Mental Health Services: The Resident Assessment Instrument—Mental Health

“…Urbanoski et al imply that the RAI-MH system was developed outside of real-world contexts when, in fact, front-line clinicians were engaged in all aspects of the development and refinement of the instrument and its applications. Numerous studies since the development work were based on data collected within routine clinical practice, including research on the Cognitive Performance Scale,2 Clinical Assessment Protocols,3,4 and quality indicators 5…”

The interRAI Suite of Mental Health Assessment Instruments: An Integrated System for the Continuum of Care

“…The interRAI ESP triggers mainly the patient safety related CAPs as priority issues for crisis situations. Previous publications have highlighted triggering patterns and outcomes associated with the CAPs for traumatic life events (288), education and employment (289), and harm to others (262). Figure 2 shows the triggering rates for patient safety CAPs by homelessness in different service settings.…”

“…For example, the CAP for traumatic life events (288) targets two sub-groups for intervention: a) persons who face immediate threats to their safety due to assaults, abuse or criminal victimization that has occurred within the last 7 days; and b) persons who experienced potentially traumatic life events and who described those events as inducing a sense of intense fear or horror. The latter group were found to have elevated rates of PTSD related symptoms (288). However, from a population perspective it is also sometimes useful to examine patterns of lifetime exposure to adverse circumstances to inform policy development.…”