An investigation into trauma-informed care within mental health inpatient settings

Section A is a systematic review of the effectiveness and impact of Trauma Informed Care (TIC) training for mental health inpatient staff. Seventeen papers identified various training designs, content, timings, facilitators, staff included,and outcome measures. TIC training had positive impacts on staff and clients in the short, medium, and long-term. Barriers and facilitators to impactful training included documentation of TIC changes, support of staff, and leadership support. Training heterogeneity, unvalidated outcome measures, and varied methodologies, impeded on conclusive strength. Future research could use high quality longitudinal designs, control groups, multi-sites, validated measures, and mixed methods.

Section B presents a mixed-methods investigation into the current culture of mental health inpatient wards and the potential role of Trauma-Informed Care, introduced through staff workshops. Various professionals (n = 31) completed quantitative measures assessing TIC awareness, attitudes, and restrictive practice. Participants were invited to a TIC-workshop, followed by a semi-structured interview reviewing the feasibility and impact of the workshop, analysed using Reflexive Thematic Analysis (RTA). 39% of staff were involved in restrictive practice, these were severe and detrimental to staff and clients. Above average TIC attitudes and climate were found, however systemic challenges were indicated. RTA highlighted positive workshop impacts, however conceptual and practical barriers, such as lack of leadership support, were also identified.