Trauma Informed Care

Trauma-informed care is an existing standard of care and practice that a wide range of professionals can adopt in their work with trauma survivors.

Ultimately, it helps make sure the survivors aren’t re-traumatised whilst trying to access the compassionate, validating help they need.

Unfortunately, the majority of public services (including schools, prisons and hospitals) and their staff don’t know about trauma or trauma-informed care. It’s our mission to campaign for not only its awareness but widespread adoption as common practice.

This really could change lives. If any of of the hundreds of professionals who I have had emotional flashbacks in front of my whole life had been trauma-informed, and if any one of the schools or hospitals I had been to had implemented trauma informed care & practice, my childhood trauma would have been picked up on and dealt with properly before it had a chance to turn into full blown Complex PTSD which I will now spend the rest of my adult life healing from.

It really is the very least we can do to help those who need our support the very most. The best bit is, it’s not complicated (the principles are validating someone’s experiences and compassionately supporting them to heal) and it can have very positive outcomes.

To give you of an idea of how this translates into the real world, we’ve started to compile a collection of things which don’t work for trauma survivors when trying to access help through the traditional western medical system. We’ve added our ideas to make things better from a trauma-informed care & practice approach, illustrating how this can work, and better serve complex trauma survivors.

Problem: Triggering care environments

Depending on the trauma, certain NHS & medical settings may be triggers for Complex PTSD survivors. Trying to then find help in these same settings is a bit like telling a war veteran to go back to the battlefield to heal.

Solution: Waiting room angels

Very simply, waiting rooms in mental health clinics/hospitals could be decorated in a less clinical way. If you’ve ever paid for private therapy, and also experienced NHS therapy, you’ll have noticed the difference between the waiting rooms and therapy rooms of each settings. It would be great to do a DIY-SOS style revamp of at least NHS mental health waiting rooms, if not therapy rooms too, around the country.

Problem: No Thinking Outside The Box

Experiencing the traditional therapy room as a particular trigger related to my trauma, I have often ended up having emotional flashbacks in a setting like this. Unfortunately nobody ever recognised these as emotional flashbacks related to trauma, or knew how to deal with them. Thinking outside the box just a little and taking me out of that environment to a safe place outside would really have helped, but often NHS staff aren’t allowed to do this.

Solution: Create outdoor therapy / break-out spaces

Quite simply, every NHS therapy setting should have access to a safe (e.g. private; not alongside a main road) outside space to be used when needed during therapy sessions. This can be as simple as a bench outside. Or even some big wooden tree stumps to sit on. Anything to break the conventional setting which can easily be a trigger for trauma survivors, and begin to ground them again in the calming and mindful setting of nature.

Problem: Need for a permanent fixed address

Alongside the many other struggles, for some people with complex PTSD, homelessness can sadly be an issue. With lots of triggers making it impossible for us to live alongside others in normal house shares, or to earn enough of a living to rent our own accommodation, the effects of complex trauma really do seriously affect every aspect, and even the most basic that others take for granted, of our lives. Some of us turn to unconventional solutions to keep a safe roof over our heads, including living in vans or indeed on boats. Sometimes this means having to live ‘under the radar’, not wanting to draw attention to yourself and going without a conventional fixed address. Have you ever tried to register at a GP without an address? Or receive letters of your appointments? Or call 111 for an emergency prescription? Or get funding from a local CCG to fund the care you need? All impossible without an address. And if you’re in a situation where you feel like you have to stay hidden – whether you’re illegally sub-renting or living in a mobile caravan – you’re not going to be able to seek help when you need it. Even things like visits from local community mental health teams can become impossible in these situations. And with a disproportionate number of homeless people also suffering with complex PTSD, it’s a circular and vicious cycle to be stuck in.

Solution: Create alternative pathway specifically for people with Complex PTSD & no fixed abode

Can we create a universal address for everyone struggling with trauma and without a fixed abode? A lot of my trauma is about not getting help, and feeling homeless – so every time I try to explain to a healthcare professional that I live on my boat, and every time they say they can’t help me or I need to prove my address, it’s a trigger. Instead, I could reply with my eyes on trauma address, a bit like a PO Box. If all healthcare professionals were trauma informed as we are calling for, then they would immediately recognise and understand what this address meant, and would know not to ask any more triggering questions about being homeless. The best bit about this idea is that the post to these addresses could either be forwarded to a nominated temporary address (e.g. your current hostel or friend’s house), or it could even be centrally opened and organised and scanned in on behalf of patients – almost acting like a virtual PA – and emailed to them or a carer, with text message info of important appointment dates from these letters. One of the most difficult things to manage when you are homeless and struggling with Complex PTSD is keeping on top of your appointments, so this could be a great way of giving people a genuine helping hand.

We need to address wider systemic issues, and could also investigate creating alternative access pathways into trauma services which are universally and centrally offered, rather than tied to local healthcare commissioning groups.

Have you had an experience that you think could have been better, from a trauma-informed perspective? Please share your ideas with us and we’ll include them here, hopefully the first step in making them happen.