Trauma-informed care for people presenting to the emergency department with mental health issues

Molloy, Luke; Fields, Lorraine; Trostian, Baylie; Kinghorn, Grant

doi:10.7748/en.2020.e1990

Cited by 13 publications

(2 citation statements)

References 41 publications

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“…These guiding principles demonstrate distinct yet related benefits (30), and are measurable across an organization (30,31). TIC has been implemented in psychiatric (32), justice (33,34), medical (35), and child/youth welfare systems (36), for both outpatient and residential services. Benefits of TIC include greater staff satisfaction, retention, commitment, and performance (37).…”

Section: Trauma-informed Care At a Service Levelmentioning

confidence: 99%

Study protocol: implementing and evaluating a trauma-informed model of care in residential youth treatment for substance use disorders

Walter,

Carlyle,

Kerswell

et al. 2023

Front. Psychiatry

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IntroductionComorbidity between Substance Use Disorders and trauma/post-traumatic stress disorder (PTSD) is common, particularly within residential treatment services. Comorbidity is associated with poorer treatment retention and treatment outcomes. Integrated treatment approaches are increasingly recommended but are still under examined in residential treatment services. This study will implement and evaluate a novel model of trauma-informed care (TIC) in a youth (18–35 years) residential substance use treatment service.Methods and analysisA single-armed, phase 1 implementation trial will be conducted in one residential treatment service. The model, co-developed with staff, incorporates: (i) workforce development in TIC through staff training and clinical supervision; adaptions to the service (ii) policies, procedures, and physical settings and (iii) treatment program adaptions (in delivery style and content) to be more trauma-informed; (iv) client screening and feedback for trauma and PTSD at service entry; and (v) the provision of support, referral and/or trauma-focused therapy to those with PTSD. Service outcomes will include adherence to the TIC model and client treatment completion. Client substance use and mental health measures will be collected at service entry, and 1-, 3-, 6- and 12-months follow up. Staff outcomes, including workplace satisfaction, burnout, and fatigue, as well as perceptions and confidence in delivering TIC will be collected at baseline, and at 3-, 6-, 12- and 18-months following training in the model. The sustainability of the delivery of the TIC model of care will be evaluated for 12 months using service and staff outcomes.Ethics and disseminationThe study has received ethical approval by the University of Queensland (Approval number: 2020000949). The results will be disseminated through publication in a peer-reviewed scientific journal, presentations at scientific conferences, and distributed via a report and presentations to the partner organization.Clinical trial registration: ACTRN12621000492853.

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Section: Trauma-informed Care At a Service Levelmentioning

confidence: 99%

Study protocol: implementing and evaluating a trauma-informed model of care in residential youth treatment for substance use disorders

Walter,

Carlyle,

Kerswell

et al. 2023

Front. Psychiatry

View full text Add to dashboard Cite

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“…The ED setting, with its sensory overload and perceived loss of privacy and control, can be a difficult environment for patients with a history of trauma. The resulting retraumatization can lead to behaviors rooted in a trauma response, such as patients being “combative” or labeled as “difficult.” 12 A trauma‐informed approach can allow ED staff to recognize these trauma responses and effectively help patients to de‐escalate and engage in care. In addition to providing effective tools to care for patients, trauma‐informed approaches are crucial for the well‐being of ED staff members, who frequently experience both direct and secondary (vicarious) trauma.…”

Section: Introductionmentioning

confidence: 99%

Factors that influence interprofessional implementation of trauma‐informed care in the emergency department

et al. 2023

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BackgroundTo describe factors that influence interprofessional staff decisions and ability to implement trauma‐informed care (TIC) in a level‐one emergency department (ED) trauma center.MethodsThis qualitative research study consisted of semi‐structured interviews and quantitative surveys that were conducted between March and December 2020 at an urban trauma center. Eligible participants were staff working in the ED. Interview questions were developed using the Theoretical Domains Framework (TDF), which is designed to identify influences on health professional behavior related to implementation of evidence‐based recommendations. Interview responses were transcribed, coded using Atlas software, and analyzed using thematic analysis.ResultsKey themes identified included awareness of TIC principles, impact of TIC on staff and patients, and experiences of bias. Participants identified opportunities to improve care for patients with a trauma history, including staff training, more time with patients, and efforts to decrease bias toward patients. Most participants (85.7%) felt that a TIC plan, tiered trauma inquiry, and warm handovers would be easy or very easy to implement.ConclusionWe identified key interprofessional staff beliefs and attitudes that influence implementation of TIC in the ED. These factors represent potential individual, team‐based, and organizational targets for behavior change interventions to improve staff response to patient trauma and to address secondary trauma experienced by ED staff.

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Screening and Assessment of Suicidal Behavior in Transition-Age Youth with Foster Care Involvement

Katz

Gopalan

Wall³

et al. 2023

Child Adolesc Soc Work J

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Transition-age youth with foster care involvement (TAY, ages 17–22) are at heightened risk for suicidal behavior. Despite this, mental health screenings are not standardized across child welfare (CW) systems and existing assessment tools are not designed for use with this specific population. As such, TAY are unlikely to be adequately screened for suicide risk and connected with needed services. In this paper, we sought to identify screening and assessment tools that could be effective for use with TAY in CW settings. Using PubMed and PsycINFO, we conducted a search of the current literature to identify some of the most commonly used screening and assessment tools for youth. We then narrowed our focus to those tools that met predefined inclusion criteria indicating appropriateness of use for TAY in CW settings. As a result of this process, we identified one brief screening tool (the ASQ) and four assessments (the SIQ-JR, the C-SSRS, the SHBQ, and the SPS) that demonstrated specific promise for use with TAY. The strengths and limitations of the tools are discussed in detail, as well as the ways that each could be used most effectively in CW settings. We highlight three key points intended to guide social work practice and policy: (1) systematic, routine assessment of mental health and suicide risk across CW settings is critical; (2) the protocol for assessing suicidal behavior in TAY must account for the wide variations in context and service provision; and (3) CW workers administering assessments must be thoughtfully trained on risk identification and the protocol implementation.

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Trauma-informed care for people presenting to the emergency department with mental health issues

Cited by 13 publications

References 41 publications

Study protocol: implementing and evaluating a trauma-informed model of care in residential youth treatment for substance use disorders

Study protocol: implementing and evaluating a trauma-informed model of care in residential youth treatment for substance use disorders

Factors that influence interprofessional implementation of trauma‐informed care in the emergency department

Screening and Assessment of Suicidal Behavior in Transition-Age Youth with Foster Care Involvement

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