In my previous post we spoke about re-traumatization, what it is, and how it can happen within the mental health system. Now it’s well and good for me to sit here and say what is wrong with the system, but can it be fixed? The short answer is yes. Most systems are capable of reform if the work is put in. Mental health care has changed drastically in the last 50-60 years. Gone are the days when you could be put in an asylum just for having a child out of wedlock or even being unhappy with your housewife lifestyle. Although flawed we have a mental health act and a human rights act. Treatment is not yet where we want it to be, but we’ve stopped drilling into people’s heads for the most part.
I’ve recently been through some peer support worker training and training on working with personality disorder. This has been so valuable to me, both professionally and personally. It’s helped me come up with some ideas around how we can work on this issue.
5 Steps to Trauma Informed Care
Train staff on trauma and how it works - There is no point in setting up your service to be trauma informed if you don’t bother to train staff. It sounds silly, but I’ve seen it happen. New policies are put in place, but no one even knows they exist. For a topic as serious and complex as trauma, I would suggest a whole day of training; this should include someone with lived experience co-delivering it.
Get to know the person you are working with - work with the whole person and not the diagnosis. No two people handle trauma the same way.
Ask the person if they would like to make advanced decisions - What does this person want to happen in the event of an acute episode where staff may need to intervene? They may ask not to be restrained in a certain way as it reminds them of their trauma. Maybe there is something else that helps them when they are in distress that staff don’t know of.
Consider gender, sexual orientation and race - many people have experienced trauma because of their protected characteristics. It’s been shown that race plays a huge part in the choice to restrain and detain people. Consider if someone with sexual trauma may not want the opposite gender involved in their personal care.
Involve peer support workers (PSWs) - many people under mental health services find it easier to talk to them, because they have less power over them than a nurse. A PSW isn’t going to get you sectioned if you say the wrong thing. PSWs often have their own experience of trauma and so are able to empathise more easily.
As someone who has used services for over 10 years and worked in mental health for almost as long, trauma informed care is essential to recovery. This advice is based on evidence and if it changes the way just one mental health worker thinks, then I'll be happy.
For those of you who are under mental health services, I would suggest trying to find a Service User Network in your area, by asking your nurse or therapist. These are usually run by those with lived experience and allow service users to have a voice in decisions being made by the NHS. It’s a really effective way to bring about change within the service. The old saying is true ‘there is safety in numbers’, but there is also power.
