Tags: redesigning care

Trauma can have significant, long-term negative effects on health and mental health. The experience of adverse events – both physical and emotional – as well as negative incidents, like substance abuse and mental health, can cause distress for individuals, communities, and populations that can be felt across generations.

The experience of trauma is pervasive. About two-thirds of adults have experienced at least one form of trauma in their lives, and one in five adults have experienced three or more adverse experiences during their lifetime. As the number of trauma experiences increases, so too does the risk for many health conditions, like depression, asthma, obesity, diabetes, smoking and substance use disorder, disability, unemployment, and lower educational attainment, among other effects.

The experience of trauma can also influence how people access and experience healthcare. For some people, accessing healthcare services can be re-traumatizing and the health care system can improve its approaches to support patients. Moreover, trauma experiences not only have an adverse effect on individuals seeking care, healthcare providers may experience negative effects in caring for trauma survivors.

To draw attention to the significant and sometimes cumulative effects of trauma, in 2012, we established the Partners Trauma-Informed Care Steering Committee with the aim of creating a culture of trauma-informed care across all Partners Institutions, through research, education, policy and environmental changes. 

The Partners Trauma-Informed Care Steering Committee held its 4th Annual Symposium earlier this fall. The Symposium included a visit from Dr. Carol Warshaw, Director of the National Center on Domestic Violence, Trauma and Mental Health, followed by a panel discussion highlighting some of the many ways we are incorporating trauma-informed care in our practices.

Three panelists from our organization shared how the trauma-informed care approach is being implemented across our practices:

  • Constance Cruz, RN MS Clinical Nurse Specialist, MGH Inpatient Psychiatry is a psychiatric mental health clinical nurse specialist. In her remarks, Cruz explained how the inpatient psychiatric unit relies on the trauma-informed care as a clinical framework, specifically in primary prevention and behavior support for patients.  
  • Jennifer Kelly, MSW Director, Healthy Chelsea Coalition, Chelsea Health Center, is a social worker and also the director of Healthy Chelsea, a community coalition focused on improving the health of the residents of Chelsea. In these roles, Kelly uses trauma-informed care to focus on early childhood toxic stress and is working to make Chelsea a “trauma informed city.” 
  • Wendy Macias Konstantopoulos, MD, MPH, Director, MGH Human Trafficking Initiative; Chief Executive/Medical Director, MGH Freedom Clinic MGH.  She is also the co-founder and Director of the MGH Human Trafficking Initiative. In her panel discussion, Dr. Konstantopoulos spoke to her reliance on trauma-informed care in her work as an attending physician in the MGH Emergency Departmen,t and as a structure to support human trafficking survivors through the MGH Freedom Clinic.

How we respond to trauma as healthcare providers can make a lasting, positive impact in the lives of our patients and may improve health outcomes and cost effectiveness. Our clinicians are finding ways to incorporate meaningful, culturally-relevant and person-centered opportunities for all patients to feel empowered, not just those with known trauma experiences. In our practices, we strive to integrate this approach every day, into all that we do, from parking and reception, through our hiring practices, policies, culture and our care environments to ensure that we are supportive of the experience of our patients and providers.