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The purpose of this paper is to describe and explain trauma-informed approaches (TIAs) to mental health. It outlines evidence on the link between trauma and mental health, explains the principles of TIAs and their application in mental health and explores the extent to which TIAs are impacting in the UK.

The approach is a conceptual account of TIAs including a consideration of why they are important, what they are and how they can become more prevalent in the UK. This is supported by a narrative overview of literature on effectiveness and a scoping of the spread of TIAs in the UK.

There is strong and growing evidence of a link between trauma and mental health, as well as evidence that the current mental health system can retraumatise trauma survivors. There is also emerging evidence that trauma-informed systems are effective and can benefit staff and trauma survivors. Whilst TIAs are spreading beyond the USA where they developed, they have made little impact in the UK. The reasons for this are explored and ways of overcoming barriers to implementation discussed.

This paper – authored by trauma survivors and staff – describes an innovative approach to mental health service provision that, it is argued, could have immense benefits for staff and service users alike.

Mental health services have changed significantly in the past few decades. Currently, our services are transforming from one that was biomedically led to one that encompasses a recovery orientation. Additionally, a new field of study as it related to mental health care is emerging that of trauma-informed care. In this chapter, we explore briefly what we mean by the terms trauma and trauma-informed care. This is followed by a critical examination of how co-production and servant leadership can work together to support individuals through their trauma towards recovery and well-being. From which, we suggest that peer support workers are suitable candidates to co-produce trauma-informed services as they embody the connecting principles of choice and empowerment needed for all three concepts to converge and work together to enhance recovery and well-being. While I focus on using co-production in the mental health space in this chapter, the principles and practices can equally apply to other health and social care services.

In the previous chapters, I set out a conceptual model of trauma-informed servant leadership and discussed servant leadership supervision for working with burnout, compassion fatigue and secondary trauma in employees within trauma related health and social care settings. In this chapter, I further extend servant leadership to the peer support principle in trauma-informed approaches (Substance Abuse and Mental Health Services Administration, 2014). The first part of this chapter will examine peer support work (PSW) and report on the outcomes associated with it. Then, servant leadership will be discussed and used to operationalise the principle of peer support as set out in trauma-informed approaches. A servant leadership peer support approach is put forward with a theoretical basis. This theoretical model has been slightly changed from the previous servant leadership approaches discussed, in order to represent the PSW role more accurately. However, as discussed previously, it is not the characteristics of the Servant leadership (SL) model that define the approach, rather the philosophy and desire to serve first. In the last section of this chapter, Martha Griffin brings the characteristics of this model to life using her vast experience and discusses some of the potential challenges faced by peers in training and practice.

Purpose – This chapter discusses the promise of and challenges to providing effective and culturally responsive trauma-focused mental health services to immigrant and refugee youth and their families within school settings.

Design/methodology/approach – This chapter utilizes “practice-based evidence” to outline successes and address the barriers associated with the implementation of school-based, trauma-focused, evidence-based interventions in four immigrant or refugee-dense cities: Los Angeles, Chicago, Minneapolis, and Boston.

Findings – Making cultural adaptations to identified trauma interventions that were consistent with community priorities, cultural norms, and values resulted in more accessible programs and greater engagement in treatment services.

Practical implications – The strategies tested in these real-world settings contribute to the development of culturally competent trauma-informed services for immigrant and refugee youth and their families. Mental health providers and program developers will better understand the need for multilevel engagement strategies and for culturally driven modifications when employing evidence-based programs with immigrant and refugee youth.

Originality/value – This chapter adds to the scarce evidence about useful methods to engage immigrant and refugee youth and families in treatment and to increase the likelihood of positive outcomes.

In this chapter, an overview of the trauma-informed approach is described. The background and context to trauma, its impact on the person, and organisational responses are considered. More specifically, I distinguish between trauma specific and non-specific organisations by defining the characteristic of each. This chapter sets the tone for the remainder of the book by introducing a conceptual model for both specific and non-specific trauma organisations. In order to do this, I outline the differential components that are deemed necessary for organisations to be trauma-responsive; in doing so, I introduce the Trauma Ecology Model to the literature, outlining its various components.

This paper aims to highlight emerging research relating to the need to recognise and address trauma in mental health service users.

The author searched for papers on trauma-informed care, published in the past two years.

One paper reports ideas of service users and family members for trauma-informed mental health services. A second paper describes an online survey seeking agreement between staff and service users of early intervention services for psychosis about practices of trauma-informed care. Both papers feature themes about safety and staff having training and support for asking about and responding to trauma. A third paper reports on specific therapies for trauma with people who experience psychosis. It found some evidence for talking therapies but noted that people with a psychosis diagnosis are rarely offered such therapies.

These papers highlight an emerging consensus about essential components of trauma-informed care and the need for staff training and support to realise it. The exclusion of people with a psychosis diagnosis from specific trauma therapies might begin to be addressed if services were more able to recognise trauma. There is some evidence that talking therapies for childhood trauma can be helpful for people who have a psychosis diagnosis. However, evidence reviews should be broadened to include a range of distressing experiences recognised to follow childhood trauma irrespective of whether the person has a psychosis diagnosis.

Exposure to trauma in childhood can have lasting impacts upon development and psychological well-being. Services can be sought to help young people heal from their experiences; however, literature suggests that their care may not always be trauma-informed. This paper aims to generate a theory to explain caregivers’ experiences of accessing mental health and therapeutic services for young people exposed to developmental trauma.

A constructivist grounded theory approach was used, using an iterative process of data collection and analysis. Nine individuals including foster carers, adoptive parents and a special guardian were interviewed following purposive and theoretical sampling. Techniques of initial, focused and theoretical coding, alongside constant comparative analysis were used to develop the end theory.

The theory demonstrates that multiple factors can impact upon caregivers’ experiences when accessing support for young people exposed to trauma. Six themes emerged documenting caregivers’ journeys from the decision to seek support to the ending of service involvement. Barriers, challenges and positive experiences are described. Results are contextualised through consideration of wider organisations and systems.

The theory highlights challenges caregivers face when accessing mental health and therapeutic support for young people exposed to developmental trauma. It provides new insights into what caregivers consider to be trauma-informed experiences of care in these settings. Tentative recommendations are provided in the hope of improving future care.

By older adulthood, the majority of individuals will have experienced at least one traumatic event. Trauma-informed care (TIC) is proposed to improve effectivity of health-care provision and to reduce likelihood of services causing retraumatisation. This study aims to assess the effectiveness of staff training in TIC in older adult services.

TIC training was delivered across eight Older Adult Community Mental Health Teams in the same UK organisation. Questionnaires were administered before and after training: a psychometrically robust measure, the Attitudes Related to Trauma-Informed Care, was used to assess TIC-related attitudes, and a service-developed scale was used to measure changes in TIC competence. Data was analysed using linear mixed effects modelling (LMM). Qualitative data regarding the impact of training was gathered one month after training through a free-text questionnaire.

There were 45 participants, all of whom were white British. LMM on pre- and post-data revealed that staff training significantly increased competencies across all measured TIC domains. Overall, staff attitudes were also significantly more trauma-informed after training. Qualitatively, staff identified time as the only additional resource required to deliver the skills and knowledge gained from training.

Training was found to be effective in increasing TIC-related skills and attitudes. Organisations aiming to become trauma-informed should consider staff training as one aspect of a wider development plan.

To the best of the authors’ knowledge, this paper is the first to examine TIC training for staff working in Older Adults Mental Health Services. Recommendations for services aiming to develop a trauma-informed culture have been provided.

The goal of this review is to conduct an exploratory literature review on trauma-informed approaches in libraries to understand how librarians are discussing trauma-informed approaches and their integration into professional practice.

The author reviewed materials indexed in selected EBSCOHost databases. Included materials from selected EBSCOHost databases were available to the author in full text, in the English language and about trauma-informed approaches in libraries. Items were excluded from this review if they were a review of another work, a thesis or dissertation, or letters to or from the editor.

Twenty-five publications were included in this analysis. Publications included described approaches in school libraries, academic libraries and public libraries. Key topics are racial trauma-informed practices, trauma-informed teaching, resisting re-traumatization, social work and the effects of workplace trauma on the library workforce.

Trauma-informed approaches are gaining popularity in a variety of disciplines as the world copes with the turbulent events of recent years. The practical implications of this review are to explore the emergence of trauma-informed approaches in libraries to understand the current publishing landscape on this topic.

While librarians are writing about this approach and some are incorporating it into their practice, an analysis in the form of an exploratory literature review to summarize this work has not been done. Understanding how libraries are incorporating this trauma-awareness and trauma-informed principles into the work is crucial for identifying the future approach to library services.

School violence can cause or exacerbate individual and collective trauma. Trauma-informed school approaches offer schools and educators guidance for how to respond. In this chapter, we provide an overview of trauma-informed school approaches and their contributions to healing individual and collective trauma. We begin this chapter by addressing the complex intersection of disability and trauma, and the unique implications of school-based violence for students with disabilities and their teachers. We then define trauma-informed care, describe current short- and long-term trauma-informed school approaches, and explain the aims of these approaches at individual and collective levels. Next, we locate trauma-informed responses to school violence in a context of systemic trauma and share considerations for disrupting the systemic conditions that perpetuate trauma and school violence. We discuss critiques of the trauma-informed care movement and conclude with recommendations for scholars pursuing research in this area.