Trauma-Informed Mental Health Care

Trauma-informed mental health care considers how past or current trauma may alter a client’s perception of threat, control, touch, authority, and bodily sensations. It is a way of organizing care, not a diagnosis, and it does not require the client to disclose traumatic details. Its five guiding principles are safety, trustworthiness and transparency, choice, collaboration, and empowerment. The nurse has two simultaneous responsibilities: prevent avoidable retraumatization and identify present danger. A guarded, startled, withdrawn, or dissociated client may be responding to perceived threat rather than deliberately refusing care. Those behaviours do not, by themselves, establish post-traumatic stress disorder, psychosis, intoxication, or incapacity. The next question is not “Why is this client being difficult?” but “What might this behaviour be communicating, and is anyone in immediate danger?”