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The Urgent Need for Trauma-Informed Healthcare

Violence and trauma are at epidemic levels. Our healthcare system can help.

As more brave women and men talk about their histories of sexual trauma, and as more brave veterans educate us on the impact of war, the epidemic of trauma and post-traumatic stress is coming out of the shadows. Regardless of which side of the political aisle we sit on, most of us actually agree on something: If someone we care about has survived trauma and violence, we want them to get the help they need.

Trauma is prevalent in our culture. There is almost no doubt that healthcare providers will see patients who have been impacted—as approximately 1 in 5 women report a history of adult sexual trauma, and 1 in 4 girls and 1 in 20 boys experience childhood sexual abuse. Approximately 1 in 10 seniors report elder abuse in the form of sexual, emotional, or physical abuse, or financial control. Seven percent of the population has been exposed to combat in a war zone, either as a part of military service or as a refugee/immigrant.

The one thing that all of these people have in common is that that they are going to go visit a hospital or clinic at some point in their lives. If we want to help people heal and live meaningful lives after trauma, we need to advocate for trauma-informed healthcare systems, where every doctor, nurse, dentist, pharmacist, and allied health professional understands the prevalence and impact of trauma, and promotes resilience and healing.

What Is Trauma-Informed Healthcare?

The simplest part of trauma-informed health care involves a “universal trauma precautions” approach that doesn’t require a provider to know an individual patient’s trauma history. Most people don’t like getting poked and prodded by the dentist or doctor, and if you are a survivor of trauma, this can be even more stressful. From the perspective a survivor of childhood sexual abuse, for instance, the first pelvic exam might be terrifying. For a veteran with PTSD, having to lie down at the dentists’ office and hear the sound of the drill might be unbearable. Good patient-centered care strategies can help everyone, but they may particularly benefit trauma survivors.

Healthcare providers are also in a unique position to ask people about how they are coping and what kinds of life stressors they have experienced. This is particularly true when providers have long-term relationships with patients and can provide integrated care across specialties. Survivors of violence and trauma—particularly people who have experienced multiple traumatic events—often have a heavy disease burden, both in terms of mental health and physical health problems. Finding ways to engage them in healthcare before problems accumulate is not only compassionate; it may be cost effective in the long-term. Some would say that only patients with good health insurance currently have this luxury, and they would be right. Trauma informed care means that every American can access affordable, integrated health services.

From the #MeToo movement to the discussion of veteran suicides to the lack of institutional protections for sexually abused boys in the Catholic Church, we may feel that trauma is everywhere. However, there are things we can do to help people heal and live meaningful lives. Health care providers are in the unique position to build trusting relationships, react sensitively, and refer people to the services they need. The next time you are at your doctor’s office, ask them if they have heard of trauma informed healthcare. Ask your elected officials if they support efforts to create trauma informed hospitals and communities, which involve collaborations between healthcare, behavioral health, and neighborhood resources. All it takes is one supportive, buffering relationship to change the course of someone’s life.

About the Author
Sheela Raja Ph.D.

Sheela Raja, Ph.D., is a clinical psychologist and Associate Professor at the University of Illinois at Chicago. She is the author of Overcoming Trauma and PTSD, The PTSD Survival Guide for Teens, and more

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