A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care
Abstract Experiences of trauma in childhood and adulthood are highly prevalent among service users accessing acute, crisis, emergency, and residential mental health services. These settings, and restraint and seclusion practices used, can be extremely traumatic, leading to a growing awareness for th...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-08-01
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| Series: | BMC Psychiatry |
| Online Access: | https://doi.org/10.1186/s12888-023-05016-z |
| _version_ | 1797451846876397568 |
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| author | Katherine R. K. Saunders Elizabeth McGuinness Phoebe Barnett Una Foye Jessica Sears Sophie Carlisle Felicity Allman Vasiliki Tzouvara Merle Schlief Norha Vera San Juan Ruth Stuart Jessica Griffiths Rebecca Appleton Paul McCrone Rachel Rowan Olive Patrick Nyikavaranda Tamar Jeynes T. K Lizzie Mitchell Alan Simpson Sonia Johnson Kylee Trevillion |
| author_facet | Katherine R. K. Saunders Elizabeth McGuinness Phoebe Barnett Una Foye Jessica Sears Sophie Carlisle Felicity Allman Vasiliki Tzouvara Merle Schlief Norha Vera San Juan Ruth Stuart Jessica Griffiths Rebecca Appleton Paul McCrone Rachel Rowan Olive Patrick Nyikavaranda Tamar Jeynes T. K Lizzie Mitchell Alan Simpson Sonia Johnson Kylee Trevillion |
| author_sort | Katherine R. K. Saunders |
| collection | DOAJ |
| description | Abstract Experiences of trauma in childhood and adulthood are highly prevalent among service users accessing acute, crisis, emergency, and residential mental health services. These settings, and restraint and seclusion practices used, can be extremely traumatic, leading to a growing awareness for the need for trauma informed care (TIC). The aim of TIC is to acknowledge the prevalence and impact of trauma and create a safe environment to prevent re-traumatisation. This scoping review maps the TIC approaches delivered in these settings and reports related service user and staff experiences and attitudes, staff wellbeing, and service use outcomes. We searched seven databases (EMBASE; PsycINFO; MEDLINE; Web of Science; Social Policy and Practice; Maternity and Infant Care Database; Cochrane Library Trials Register) between 24/02/2022-10/03/2022, used backwards and forwards citation tracking, and consulted academic and lived experience experts, identifying 4244 potentially relevant studies. Thirty-one studies were included. Most studies (n = 23) were conducted in the USA and were based in acute mental health services (n = 16). We identified few trials, limiting inferences that can be drawn from the findings. The Six Core Strategies (n = 7) and the Sanctuary Model (n = 6) were the most commonly reported approaches. Rates of restraint and seclusion reportedly decreased. Some service users reported feeling trusted and cared for, while staff reported feeling empathy for service users and having a greater understanding of trauma. Staff reported needing training to deliver TIC effectively. TIC principles should be at the core of all mental health service delivery. Implementing TIC approaches may integrate best practice into mental health care, although significant time and financial resources are required to implement organisational change at scale. Most evidence is preliminary in nature, and confined to acute and residential services, with little evidence on community crisis or emergency services. Clinical and research developments should prioritise lived experience expertise in addressing these gaps. |
| first_indexed | 2024-03-09T15:00:16Z |
| format | Article |
| id | doaj.art-bd75958f678b4b1a89b333f6bd3862b2 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-03-09T15:00:16Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-bd75958f678b4b1a89b333f6bd3862b22023-11-26T13:57:08ZengBMCBMC Psychiatry1471-244X2023-08-0123113610.1186/s12888-023-05016-zA scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health careKatherine R. K. Saunders0Elizabeth McGuinness1Phoebe Barnett2Una Foye3Jessica Sears4Sophie Carlisle5Felicity Allman6Vasiliki Tzouvara7Merle Schlief8Norha Vera San Juan9Ruth Stuart10Jessica Griffiths11Rebecca Appleton12Paul McCrone13Rachel Rowan Olive14Patrick Nyikavaranda15Tamar Jeynes16T. K17Lizzie Mitchell18Alan Simpson19Sonia Johnson20Kylee Trevillion21NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonNIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonNIHR Mental Health Policy Research Unit, Division of Psychiatry, University College LondonNIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonSouth London and Maudsley NHS Foundation TrustSection of Women’s Mental Health, King’s College LondonNIHR Mental Health Policy Research Unit, Division of Psychiatry, University College LondonCare for Long Term Conditions Research Division, King’s College LondonNIHR Mental Health Policy Research Unit, Division of Psychiatry, University College LondonNIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonNIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonNIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonNIHR Mental Health Policy Research Unit, Division of Psychiatry, University College LondonInstitute for Lifecourse Development, University of GreenwichNIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College LondonNIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College LondonNIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College LondonNIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College LondonNIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College LondonNIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonNIHR Mental Health Policy Research Unit, Division of Psychiatry, University College LondonNIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonAbstract Experiences of trauma in childhood and adulthood are highly prevalent among service users accessing acute, crisis, emergency, and residential mental health services. These settings, and restraint and seclusion practices used, can be extremely traumatic, leading to a growing awareness for the need for trauma informed care (TIC). The aim of TIC is to acknowledge the prevalence and impact of trauma and create a safe environment to prevent re-traumatisation. This scoping review maps the TIC approaches delivered in these settings and reports related service user and staff experiences and attitudes, staff wellbeing, and service use outcomes. We searched seven databases (EMBASE; PsycINFO; MEDLINE; Web of Science; Social Policy and Practice; Maternity and Infant Care Database; Cochrane Library Trials Register) between 24/02/2022-10/03/2022, used backwards and forwards citation tracking, and consulted academic and lived experience experts, identifying 4244 potentially relevant studies. Thirty-one studies were included. Most studies (n = 23) were conducted in the USA and were based in acute mental health services (n = 16). We identified few trials, limiting inferences that can be drawn from the findings. The Six Core Strategies (n = 7) and the Sanctuary Model (n = 6) were the most commonly reported approaches. Rates of restraint and seclusion reportedly decreased. Some service users reported feeling trusted and cared for, while staff reported feeling empathy for service users and having a greater understanding of trauma. Staff reported needing training to deliver TIC effectively. TIC principles should be at the core of all mental health service delivery. Implementing TIC approaches may integrate best practice into mental health care, although significant time and financial resources are required to implement organisational change at scale. Most evidence is preliminary in nature, and confined to acute and residential services, with little evidence on community crisis or emergency services. Clinical and research developments should prioritise lived experience expertise in addressing these gaps.https://doi.org/10.1186/s12888-023-05016-z |
| spellingShingle | Katherine R. K. Saunders Elizabeth McGuinness Phoebe Barnett Una Foye Jessica Sears Sophie Carlisle Felicity Allman Vasiliki Tzouvara Merle Schlief Norha Vera San Juan Ruth Stuart Jessica Griffiths Rebecca Appleton Paul McCrone Rachel Rowan Olive Patrick Nyikavaranda Tamar Jeynes T. K Lizzie Mitchell Alan Simpson Sonia Johnson Kylee Trevillion A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care BMC Psychiatry |
| title | A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care |
| title_full | A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care |
| title_fullStr | A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care |
| title_full_unstemmed | A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care |
| title_short | A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care |
| title_sort | scoping review of trauma informed approaches in acute crisis emergency and residential mental health care |
| url | https://doi.org/10.1186/s12888-023-05016-z |
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