Is trauma informed care possible in the current public mental health system?

Abstract

Objectives: As mental health services move towards implementing ‘Trauma-informed care’, there is a need to consider the challenges posed within services and systems. This paper raises some of the challenges associated with integrating TIC into the current public mental health system. . Conclusion: The lack of clarity about expectations of trauma-informed approaches causes difficulties for its integration into services, but the wider political context of mental health services is also of relevance. Transparent and ongoing debate is required about approaches to mental health care, to ensure the system meets the needs of those who require it, while questioning what other purposes it may be serving at social and political levels.

An evaluation of a trauma‐informed educational intervention to enhance therapeutic engagement and reduce coercive practices in a child and adolescent inpatient mental health unit

“…Furthermore, TIP education and implementation require a tailored focus (Kim et al., 2021) for CAMHS settings. Mental health services are delivered predominantly through a biomedical paradigm, therefore integrating TIP requires measured and collaborative implementation approaches (Isobel, 2021).…”

Impact of strengths model training and supervision on the therapeutic practice of Australian mental health clinicians

“…Poor outcomes for mental health clients remain an urgent problem, in Australia and worldwide (Isobel 2021). In part, this study was an exploration of how the Strengths Model might help overcome this within a public mental health setting.…”

Implementing Introductory Training in Trauma-Informed Care Into Mental Health Rehabilitation Services: A Mixed Methods Evaluation

“…TIC involves a systems approach and staff awareness rather than a sole focus on providing a specific group or individual trauma therapy ( 6 ). Transitioning toward TIC requires organizational change within mental health services and staff training and support ( 5 , 7 ). The literature recommends a multi-level (trauma informed, trauma skills, trauma enhanced, and trauma specialist) competency-based training structure ( 4 ).…”

“…There is also a need for an organizational response that has TIC as part of routine clinical practice and organizational governance systems ( 12 ). Recent commentaries have emphasized the challenges of implementing TIC, especially in public mental health services ( 7 , 12 ). Barriers to implementing TIC within mental health services include resourcing, organizational culture, the dominance of the bio-medical model, and clinician misconceptions ( 13 ).…”

“…Barriers to implementing TIC within mental health services include resourcing, organizational culture, the dominance of the bio-medical model, and clinician misconceptions ( 13 ). Isobel notes there can be a lack of staff clarity of what is meant by trauma and issues in sustaining attempts at implementing TIC ( 7 ). Despite the recognized need there is limited evidence to guide the effective implementation of Trauma Inform Care ( 11 ).…”