Trauma‐informed care in acute mental health units through the lifeworld of mental health nurses: A phenomenological study

Abstract

Trauma-informed care has gained increasing popularity in mental health services over the past two decades. Mental health nurses remain one of the largest occupations employed in acute mental health settings and arguably have a critical role in supporting trauma-informed care in this environment. Despite this, there remains a limited understanding on how trauma-informed care is applied to the context of mental health nursing in the hospital environment. The aim of this study was to explore what it means for mental health nurses to provide trauma-informed care in the acute mental health setting. The study design was qualitative, using van Manen's (Researching lived experience: human science for an action sensitive pedagogy. State University of New York Press, 1990) approach to hermeneutic phenomenological inquiry. A total of 29 mental health nurses participated in this study. There were three overarching themes that emerged; these entail: embodied trauma-informed milieu, trauma-informed relationality and temporal dimensions of trauma-informed mental health nursing. The study found that for mental health nurses, there are elements of trauma-informed care that extend far beyond the routine application of the principles to nursing practice. For mental health nurses working in the acute setting, trauma-informed care may offer a restorative function in practice back to the core tenants of therapeutic interpersonal dynamics it was once based upon.

In their own words: Mental health nurses' experiences of trauma‐informed care in acute mental health settings or hospitals

“…We would like to acknowledge that the methods employed in this study are built upon Wilson et al. (2023), where we initially outlined the research methodology.…”

“…Existing research on TIC in mental health settings has consistently reported that MHNs also experience trauma and re-traumatisation; with limited investigation into the role of the TIC model vis-à-vis these identified challenges (Isobel et al, 2020;Jacobwitz et al, 2015;Wilson et al, 2021). Notably, only a limited number of studies have exclusively centred on the implications of TIC for the MHN profession within hospital or acute mental health settings (Wilson et al, 2021(Wilson et al, , 2023. It is imperative to explore the implications of TIC on the MHN profession within this context to enhance the quality of care for people living with mental health conditions.…”

“…Building upon our initial findings published in Wilson et al (2023), that focused on enabling factors, we present a second iteration of our study. This phenomenological study presents findings on the lifeworld of MHNs operating in acute mental health or hospital-based environments, specifically concentrating on barriers for TIC.…”

“…This study employed (van Manen, 1984(van Manen, , 1990 four key activities in hermeneutic phenomenology, which encompassed the following steps outlined in Figure 1. We would like to acknowledge that the methods employed in this study are built upon Wilson et al (2023), where we initially outlined the research methodology.…”