Implementing Trauma Informed Care within a Primary Health Care service setting. Sarah Haythornthwaite Danielle Dyall Anthony Ah Kit

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1 Implementing Trauma Informed Care within a Primary Health Care service setting Sarah Haythornthwaite Danielle Dyall Anthony Ah Kit

2 This is who I am Minjungbal woman in Bundjalung nation With many bloodlines from around the world My mother from England Father adopted (stolen generation) Mother Work with AMSANT Dance/Cook/Connect with country Aboriginal Knowledge systems Original instructions Social Emotional Wellbeing and the interconnectedness of all Acknowledge

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4 Profile Anthony Ah Kit (Snr) Name : Anthony Ah Kit (Snr) Place of Birth : Darwin, NT (Home) Country/s : Tennant Creek Wurrumungu Jackamarra : Lawn Hill - FN Qld Waanyi Gangala Areas of Skills and Passions Social and Emotional Wellbeing (includes social and spiritual) Community Development Mental Health Awareness and Health Promotion Trauama Informed Care Provide training and prevention in the areas of Suicide Awareness and Prevention Helping people help themselves Providing food, nutrition, my ear and a helping hand to others less fortunate than myself

5 Outcomes 1.What trauma informed care (TIC) is 2. Continuum of TIC, its life cycle 3. TIC as a Continuous Quality Improvement process, and its implementation 4. Core Values of TIC

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12 Trauma Informed Care and practice provide Continuous Quality Improvement

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14 Seven Domains that are to be assessed when implementing Trauma Informed Care & Practice include: A Governance, management and Leadership B. Organisational Policies and Structure C. Consumer and Carer/Family Participation D. Direct Services to Consumers E. Healthy and Effective Workforce F. Information and Education G. Outcomes and Evaluation

15 Identify after assessment appropriate actions and prioritise Who the organisation designates to analyse assessment data Review Goals Process Time Safety Working Group administration, senior management, middle management, front-line workers, clinical service providers, support staff, peer workers, supervisors/team leaders, training staff, consumer and carer representatives/service users What supporting information required for the assessment Determine how best to complete assessment Consider the domains appropriate to each staff or sub group

16 Ten Steps Supporting Quality Improvement 1. Identify 2. Gather input from each level of the organisation, 3. Analyse the feedback. 4. Explore improvement and potential barriers. 5. Select the overall approach and specific strategies 6. Develop an implementation plan, and then present the plan to staff members and other key stakeholders not directly involved in the quality improvement process. 7. Implement the plan. 8. Reassess the new plan. 9. Evaluate the results and determine if new goals or additional problems or issues need to be addressed. 10. Repeat the first nine steps after a time period.

17 Key Features of Trauma informed Organisations Recognise that high rates of complex mental health conditions and disabilities in relating socially may be related to trauma exposure as children and adults Inclusive of all perspectives that are involved and value the clients as well as carers (kinship) contribution in all aspects of care. This Includes reflecting on ones own perspective and how this informs when consulting with clients and developing care plans Empathetic and supportive strength based language Develop flexible plans or approaches Recognise that Institutional systems and their process are often traumatising, both overtly and covertly Provide early and thoughtful diagnostic evaluation that considers broader historical experiences and its connecting factors Education and necessary support is provided to recognise and respond to the impacts of trauma experienced within clients as well as within the organisations staff Focus on what has happened to the client rather than what is wrong with you Consider safety, what it means to be safe (physically, emotionally, spiritually), take steps to ensure that clients and staff feel safe, develop safety plans Presume that every person in a treatment setting may have been exposed to abuse, violence, neglect or other traumatic experiences Know that every one has the ability to heal and find a sense of wellness within

18 The process of becoming trauma-informed is an evolutionary journey, and the principal objective should be to establish a culture that will foster best practice, natural flexibility and innovation in order to promote sustainability. The assessment process can be rescheduled as part of the action plan to measure short-term and longitudinal change.

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20 Core Values to Trauma Informed Care 1. Understanding trauma and its impacts Reduces stigma, increases knowledge, provides a framework of understanding, provides staff with skills to work with persons who have experienced trauma Develop strategies to promote understanding of trauma and its impacts that are embedded in policies and within ongoing workforce training and support.

21 Core Values to Trauma Informed Care 2. Create environments in families and in social groups where people feel physically emotionally and spiritually safe safety means different things for different people May need separate mens/womens areas, Health professionals working consistently, predictably and respectfully Need to hear from clients what makes them feel safe Providing full information about service processes in clients preferred language

22 Core Values to Trauma Informed Care 3. Culturally competent staff staff respect specific cultural backgrounds The importance of understanding how cultural context influences expressions of and responses to trauma and recovery process identifying the interventions and supports that are most effective Culturally competent services are respectful of and specific to cultural backgrounds offering and supporting opportunities for clients to engage in cultural practices, speak in their first language and offer specific foods Culturally competent staff are aware of their own cultural attitudes and beliefs, as well as those within the community in which they work

23 Core Values to Trauma Informed Care 4. Empower and support clients control Provide opportunities for clients to have a say in recovery, respect for basic human rights. Clients are supported to regain a sense of control over their daily lives and build skills that will strengthen their sense of capability Services are set up to keep clients/families/communities well informed about all aspects of service delivery, with clients having many opportunities to make decisions about their treatment and healing process

24 Core Values to Trauma Informed Care 5. Share power and governance including individuals and families in the design and delivery of programs Promoting democracy and equalisation in power differentials, sharing power and decision making in relation to day-to-day decisions as well as the review and creation of policies and procedures For example, making sure community and clients are represented on the board and involving them in design and evaluation of programs and practices

25 Core Values to Trauma Informed Care 6. Integrate and coordinate care to holistically meet the needs of individuals Maintaining holistic view of recovery Promoting networks with other providers As much as possible, bringing together all services and supports needed to enhance physical, emotional, social, spiritual and cultural wellbeing

26 Core Values to Trauma Informed Care 7. Support relationship building as a means of promoting healing Safe, authentic and positive relationships are central to healing and recovery Importance of peer relationships, peer support Safe warm interactions restore core neural pathways We learn through relationships

27 Core Values to Trauma Informed Care 8. Enable recovery Recovery is possible and achievable Instilling hope in recovery strength based work and focusing on resilience and strength of the person

28 Activity 1. Choose a Scenario 2. As a group sketch out a summary of how this scenario may look in the workplace 3. Using the knowledge of trauma informed care principles assess how trauma informed your scenario is 4. Applying the trauma informed care principles map out a process of what might need to change, what process s or systems might need to be added 5. Develop an action plan that ensures your scenario is trauma informed within the workplace