What is needed for Trauma Informed Mental Health Services in Australia? Perspectives of clinicians and managers

Abstract

Trauma Informed Care is an approach to the delivery of mental health care that requires sensitivity to the prevalence and effects of trauma in the lives of people accessing services. While TIC is increasingly emphasized in mental health policy and frameworks in Australia, people working in mental health settings have reportedly struggled to translate the values and principles into their everyday practice. This qualitative study used an experience‐based co‐design methodology to explore the potential for implementation of Trauma Informed Care into mental health services in Australia. The experiences of consumers, carers, clinicians, and managers were gathered. This paper presents the perspectives of clinicians (n = 64) and senior managers (n = 9) from across three Local Health Districts in New South Wales in Australia. All data were analysed thematically to address the research question: What is needed for Trauma Informed Mental Health Services in Australia? To be trauma‐informed, managers required: leadership at all levels, access to resource, relevant and accessible training, support for staff, resolution of wider systems issues, and clarification of the concept and actions of TIC. Clinicians identified that to be trauma‐informed they required services to: be aware of staff well‐being, support different ways of working, address workplace cultures and provide increased resources. The findings have implications for any service, team or individual seeking to implement TIC within mental health settings.

‘What would a trauma‐informed mental health service look like?’ Perspectives of people who access services

“…This study reports on synthesized data from the consumer and carer focus groups. The experiences of staff and managers are reported elsewhere (Isobel et al, 2020) and were integrated for the wider project report (NSW ACI, 2020). In recognition of the prevalence of trauma within the Aboriginal community, additional data were gathered through a concurrent series of focus groups developed and facilitated by, and for, members of the Aboriginal community.…”

“…During this workshop, all data were coded and categorized into ‘themes’ or organizing constructs (Braun & Clarke, 2006) amongst participant groups and time spent reflecting about the expressed experiences of each participant group. Following the workshop, themes were further refined and synthesized for outputs including publically available reports of all project findings (NSW ACI, 2019; NSW ACI, 2020) and academic publications of consolidated staff and manager perspectives (Isobel et al, 2020) and consumer and carer perspectives. For the current study, a second stage of analysis undertook further thematic synthesizing of the consumer and carer findings to determine the overarching shared themes presented herein.…”

Trauma‐informed qualitative research: Some methodological and practical considerations

“…An important challenge for TI care is to transfer its intent from idealistic to practical (Isobel et al . 2021a), while remaining connected to its humanistic intents. For TI research, this means holding in mind the human elements of the process and staying connected to the people behind the words, not just the data presented and their interpretive meaning.…”

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

“…13 These components are frequently not addressed in efforts towards TIC implementation in Australia, with clinicians and managers reporting expectations to model the principles of TIC while concurrently experiencing contradictory organisational pressures. 3…”

“…Efforts to implement TIC in Australia have reportedly proved difficult to sustain. 3 While there are many possible reasons for this, this paper raises some of the systemic challenges associated with integrating TIC into the public mental health system.…”