Mapping “Trauma-Informed” Legislative Proposals in U.S. Congress

Purtle, Jonathan; Lewis, Michael

doi:10.1007/s10488-017-0799-9

Cited by 28 publications

(19 citation statements)

References 64 publications

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“…However, transitioning quickly to supporting primary care with integrated behavioral health care may not be easy for organizations. Some services in integrated care are not routinely reimbursed by insurance, which could pose as a barrier in some organizations, absent alternative payment model contracting (such as accountable care organizations (ACOs)) that could encourage care that is not solely tied to fee-for-service care in the organization [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts

Yang

Landrum

Zhou

et al. 2020

General Hospital Psychiatry

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Objective To examine changes in outpatient visits for mental health and/or substance use disorders (MH/SUD) in an integrated healthcare organization during the initial Massachusetts COVID-19 surge and partial state reopening. Methods Observational study of outpatient MH/SUD visits January 1st-June 30th, 2018–2020 by: 1) visit diagnosis group, 2) provider type, 3) patient race/ethnicity, 4) insurance, and 5) visit method (telemedicine vs. in-person). Results Each year, January–June 52,907–73,184 patients were seen for a MH/SUD visit. While non-MH/SUD visits declined during the surge relative to 2020 pre-pandemic (−38.2%), MH/SUD visits increased (9.1%)—concentrated in primary care (35.3%) and non-Hispanic Whites (10.5%). During the surge, MH visit volume increased 11.7% while SUD decreased 12.7%. During partial reopening, while MH visits returned to 2020 pre-pandemic levels, SUD visits declined 31.1%; MH/SUD visits decreased by Hispanics (−33.0%) and non-Hispanic Blacks (−24.6%), and among Medicaid (−19.4%) and Medicare enrollees (−20.9%). Telemedicine accounted for ~5% of MH/SUD visits pre-pandemic and 83.3%–83.5% since the surge. Conclusions MH/SUD visit volume increased during the COVID surge and was supported by rapidly-scaled telemedicine. Despite this, widening diagnostic and racial/ethnic disparities in MH/SUD visit volume during the surge and reopening suggest additional barriers for these vulnerable populations, and warrant continued monitoring and research.

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Section: Discussionmentioning

confidence: 99%

Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts

Yang

Landrum

Zhou

et al. 2020

General Hospital Psychiatry

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“…Given the growing research on trauma and increased knowledge about the prevalence, consequences and costs associated with trauma, there have been increased efforts at the local, state and federal levels to make systems “trauma‐informed” (Lang, Campbell, & Vanerploeg, 2015). In an effort to examine the extent to which federal legislation has been proposed to advance trauma‐informed practice, Purtle & Lewis (2017) conducted a policy mapping study of federal legislative proposals from 1973 to 2015 that explicitly mentioned trauma‐informed practice. The authors identified 49 bills introduced, beginning in December 2009 with the Domestic Minor Sex Trafficking Deterrence and Victims Support Act, and observed a dramatic increase over time with 28 bills being introduced in 2015 alone.…”

Section: Introductionmentioning

confidence: 99%

PROTOCOL: Effects of trauma‐informed approaches in schools

Maynard¹,

Farina²,

Dell³

2017

Campbell Systematic Reviews

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BACKGROUND The problem, condition or issue Childhood trauma has been receiving increased attention and it is increasingly being recognized as a significant public health concern (Lang, Campbell, & Vanerploeg, 2015). Trauma exposure involves "actual or threatened death, serious injury, or sexual violence" that is either directly experienced or witnessed, or learning that any traumatic experiences have happened to a loved one, or having repeated exposure to details of traumatic events (APA, 2013, p. 271). Prevalence estimates of trauma experienced in childhood or adolescence vary by type of traumatic event (e.g., physical abuse, neglect, sexual abuse, witnessing violence, natural disasters) and how and when the traumatic experience is measured, but can range between 4% and 71% (Finkelhor et al., 2015; McLaughlin et al., 2013; Saunders & Adams, 2014). Exposure to traumatic events can disrupt brain development and can have immediate and lifelong adverse effects on social, emotional and physical wellbeing, including deficits executive functioning, developmental delays, behavioural health problems, difficulty regulating emotions and behaviour, academic performance and IQ, school behaviour problems, delinquency, substance abuse, and mental health and psychiatric disorders (Anda et al.

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“…Trauma-informed practice is also gaining traction in U.S. Congress. In 2015, 28 bills were introduced with an explicit purpose to promote trauma-informed practice (Purtle & Lewis, 2017) and similar bills are currently being considered in the 115th Congress (e.g., the Trauma-Informed Care for Children and Families Act of 2017, H.R.1757, S.774; A Resolution Recognizing the Importance and Effectiveness of S.Res.346,H.Res.443). Traumainformed practice is also receiving increasing attention in the peer-reviewed literature.…”

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confidence: 99%

Systematic Review of Evaluations of Trauma-Informed Organizational Interventions That Include Staff Trainings

Purtle

2018

Trauma, Violence, & Abuse

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159

126

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Enthusiasm for trauma-informed practice has increased dramatically. Organizational interventions that train staff about trauma-informed practice are frequently used to promote trauma-informed systems change, but evidence about these interventions' effects has not been integrated. A systematic review was conducted of studies that evaluated the effects of organizational interventions that included a "trauma-informed" staff training component. A search was conducted in July 2017 and studies were identified in PubMed, PsycINFO, and the Published International Literature on Traumatic Stress database, limited to articles published in English after 2000. Six hundred and thirty-two articles were screened and 23 met inclusion criteria. Seventeen studies used a single group pretest/posttest design, five used a randomized controlled design, and one used a quasi-experimental design with a nonrandomized control group. The duration of trauma-informed trainings ranged from 1 hr to multiple days. Staff knowledge, attitudes, and behaviors related to trauma-informed practice improved significantly pre-/posttraining in 12 studies and 7 studies found that these improvements were retained at ≥1month follow-up. Eight studies assessed the effects of a trauma-informed organizational intervention on client outcomes, five of which found statistically significantly improvements. The strength of evidence about trauma-informed organization intervention effects is limited by an abundance of single group, pretest/posttest designs with short follow-up periods, unsophisticated analytic approaches, and inconsistent use of assessment instruments. In addition to addressing these methodological limitations, priorities for future research include understanding intervention effects on clients' perceptions of care and the mechanisms through which changes in staff knowledge and attitudes about trauma-informed practice influence client outcomes.

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Mapping “Trauma-Informed” Legislative Proposals in U.S. Congress

Cited by 28 publications

References 64 publications

Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts

Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts

PROTOCOL: Effects of trauma‐informed approaches in schools

Systematic Review of Evaluations of Trauma-Informed Organizational Interventions That Include Staff Trainings

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