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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.

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.

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.

Practitioners, organisations and policy makers in health and social care settings are increasingly recognising the need for trauma-informed approaches in organisational settings, with morbidity and financial burdens a growing concern over the past few years. Servant leadership has a unique focus on emotional healing, service to others as the first priority, in addition to the growth, well-being and personal and professional development of key stakeholders. This paper aims to discuss Trauma Informed Servant Leadership (TISL).

A targeted review of the servant leadership and trauma-informed care literature was conducted. Relevant studies, including systematic review and meta-analysis, were sourced, with the resulting interpretation informing the conceptual model.

Although there are general guidelines regarding how to go about instituting trauma-informed approaches, with calls for organisational leadership to adapt the often cited six trauma-informed principles, to date there has not been a leadership approach elucidated which takes as its starting point and core feature to be trauma informed. At the same time, there is a paucity of research elucidating trauma outcomes for service users or employees in the literature when a trauma-informed approach is used. However, there is a large body of evidence indicating that servant leadership has many of the outcomes at the employee level that trauma-informed approaches are attempting to attain. Thus, the author builds on a previous conceptual paper in which a model of servant leadership and servant leadership supervision are proposed to mitigate against compassion fatigue and secondary trauma in the health and social care sector. The author extends that research to this paper by recasting servant leadership as a trauma-informed model of leadership that naturally operationalises trauma-informed principles.

A lack of primary data limits the extent to which conclusions can be drawn on the effectiveness of this conceptual model. However, the model is based on robust research across the differential components used; therefore, it can act as a framework for future empirical research designs to be studies at the organisational level. Both the servant leadership and trauma-informed literatures have been extended with the addition of this model.

TISL can complement the trauma-informed approach and may also be viable as an alternative to trauma-informed approaches. This paper offers guidelines to practitioners and organisations in health and social care on how to operationalise important trauma-informed principles through leadership.

This conceptual model may help reduce the burden of trauma and re-traumatisation encountered by practitioners and service users in health and social care settings, impacting on morbidity.

To the best of the author’s knowledge, this is a novel approach, the first of its kind.

People in prisons have a high prevalence of poly-traumatisation throughout their life span. The behavioural and emotional sequalae of trauma are likely to be managed across the whole organisation. However, there is still a lack of clarity about the key components of a trauma-informed approach within the custodial context. This study aimed to gather in-depth knowledge of staff views on the components of an optimal trauma pathway in a prison and the organisational factors that influence its implementation.

The authors’ research design is qualitative, involving in-depth, semi-structured interviews with eight members of staff from different professional backgrounds at a single prison in the UK that houses sentenced and remand prisoners. Data was analysed using reflexive thematic analysis.

Three super-ordinate themes were identified within the data. Firstly, components of a trauma-informed pathway included sub-themes of asking about what has happened and knowing how to respond; providing specialist approaches; enabling residents to cope; screening and detection; and a compassionate relational approach. Secondly, organisational factors were associated with sub-themes of culture and leadership, resources and systems and processes. Thirdly, staff factors were associated with sub-themes of skills development and training, staff well-being and support and staff attitudes.

Post-traumatic stress disorder (PTSD) and complex PTSD in prisons are under-detected, and there are complex psychosocial factors within prisons that mediate the effectiveness of psychological therapies.

To the best of the authors’ knowledge, this study represents the first exploration of staff perspectives on the components of a trauma-informed pathway within custodial settings. Future directions should involve the piloting and evaluation of the components of the trauma-informed pathway, with a focus on longer-term outcomes and exploration of the organisational factors that impact on effectiveness.

Workforce development in rural communities to address a surge in opioid addiction and overdose related hospitalizations has been an unaddressed issue in the USA. This study aims to present an integrated, trauma-informed, behavioral workforce development initiative in a midwestern rural setting in the USA.

This is a mixed method, two-phased study: the first phase tracked and analyzed two focus group conferences involving experts (n = 6) and professionals (n = 8) to develop a training protocol; the second phase provided a training (n = 101), based on the protocol to future professionals and compared competencies before and after the implementation of the training.

There is a need of a trauma integrated approach in providing interprofessional training connecting health-care workers in rural communities to address the current opioid crisis to bring about cohesion among integrated and interdisciplinary teams. Workforce building will need to implement best practices not only among medical providers but among community mental health practitioners in rural areas.

This is a unique trauma-informed workforce development initiative in a rural community. Such studies are extremely limited and almost non-existent. Further initiatives need to be taken in this field to identify unique differences within communities that may hinder implementation.

Recent years have seen significant policy and practice interest in how to best respond to the impact of childhood maltreatment and adversity on young people’s contact with youth justice systems. In Australia, this has resulted in increasing pressure to implement trauma-informed practice, although this is a term that has different meanings for different stakeholders, and little is known about the perspectives of justice-involved young people. This paper aims to review what is currently known about co-production in youth justice and discuss ways in which young people can be meaningfully involved in the development of trauma-informed practice frameworks.

A narrative approach is used to present a contextual overview of youth justice in Australia, introduce key concepts underpinning trauma-informed practice and consider the barriers and facilitators of co-production and participatory approaches to the development and implementation of trauma-informed practice.

Youth justice in Australia is widely viewed as in urgent need of reform, with broad interest in developing more trauma-informed practice in these systems. Co-production and participatory approaches are fundamental to the reform process and can help to ensure that the views and aspirations of the children for whom these systems are responsible are embedded in efforts to implement trauma-informed practice.

This paper presents an argument for implementing trauma-informed practice in Australian youth justice that is based on consultation and collaboration with young people. It does not present evidence about the potential effectiveness of such an approach.

This paper has direct implications for youth justice practice, in terms of both service philosophy, design and delivery.

The work discussed in this paper offers possibilities for new and different ways of responding to youth crime and maintaining community safety.

Whilst the need to re-imagine youth justice is widely recognised, there are few resources available to support efforts to co-produce trauma-informed practice. This paper synthesises what is known about these approaches and offers some suggestions and possible ways forward.

This study aimed to explore how forensic mental health service users make sense of their past adverse experiences. Secondly, it aimed to explore whether service users considered their adverse experiences to be related to their current stay in a forensic mental health setting.

Interpretative phenomenological analysis was used to analyse interviews with eight service users in low and medium secure care. Six of the participants were male and two were female.

Four super-ordinate themes emerged from the data: “Living amongst adversity”; “Managing adverse experiences”; “Making sense of going into secure care”; and “Coping with the past in the present”. All participants referred to multiple adverse experiences throughout their lives and used harmful coping strategies to manage these. Individual differences in how they related their past experiences to their detention in secure care were evident.

Author guidelines state that this section is optional. Implications for clinical practice are discussed at length in the discussion section.

This study offers an insight into the way in which forensic mental health service users make sense of their past traumas in relation to their current admission to secure services. To the best of the authors’ knowledge, no research has previously addressed this from the perspective of service users.

The purpose of this paper is to describe the impact of a trauma-informed care (TIC) training programme on practice at the individual and workplace level in mental health and drug and alcohol services and to examine the implications of using training alone as a strategy for achieving system-level practice change.

A total of 271 clinicians and managers from public mental health and drug and alcohol services in Western Australia who had undertaken TIC training were invited to complete an on-line survey 12 months after training. Individual survey items were based on a five-point Likert scale with opportunity being provided for additional comments from respondents.

One year post-training, both clinicians and managers reported that training had increased their awareness and knowledge and had a positive impact on their attitudes towards TIC. Clinicians reported a moderate impact on their individual practice and both groups reported very limited success in bringing about change in their workplaces. Workforce development and organisational factors were identified by both clinicians and managers as being barriers to implementation.

Only 30 per cent of the training participants responded to the survey and it is not possible to determine whether they differed from non-respondents. Findings were based on a self-report survey with no objective measure of behaviour change.

This “naturalistic” study examines the longer-term impact of training, from the perspective of clinicians and managers, on changing practice at the individual clinician and workplace level. It highlights the critical importance of understanding and addressing contextual factors where collective, coordinated behaviour change is needed in order to effect organisational change.