Trauma-Informed Approaches and Programs
SAMHSA is dedicated to promoting trauma-informed care for individuals with mental health and substance use disorders. By emphasizing safety, trust, collaboration, and empowerment, SAMHSA aims to create supportive, recovery-focused environments. Through various programs and initiatives, SAMHSA supports organizations in implementing practices that foster resilience and healing.
What is a Trauma-Informed Approach?
A program, organization, or system that is trauma-informed realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, and practices, and seeks to actively resist re traumatization.
How SAMHSA Promotes Trauma-Informed Care
Trauma-informed approaches recognize and intentionally respond to the lasting adverse effects of experiencing traumatic events. SAMHSA defines a trauma-informed approach through six key principles:
- Safety: participants and staff feel physically and psychologically safe.
- Peer support: peer support and mutual self-help are key as vehicles for establishing safety and hope, building trust, enhancing collaboration, and utilizing their lived experience to promote recovery and healing.
- Trustworthiness and Transparency: Organizational decisions are conducted with the goal of building and maintaining trust with participants and staff.
- Collaboration and Mutuality: importance is placed on partnering and leveling power differences between staff and service participants.
- Cultural, Historical, & Gender Issues: culture and gender-responsive services are offered while moving beyond stereotypes/biases.
- Empowerment, Voice and Choice: organizations foster a belief in the primacy of the people who are served to heal and promote recovery from trauma.
What is Seclusion and Restraint?
Seclusion and restraint were once perceived as therapeutic practices in the treatment of people with mental and/or substance use disorders. Today, these methods are viewed as traumatizing practices and are only to be used as a last resort when less-restrictive measures have failed, and safety is at severe risk. They are defined as:
- Seclusion: The involuntary, solitary confinement of an individual.
- Restraint: Any method, physical or mechanical device, or material or equipment that immobilizes or reduces an individual’s ability to freely move his or her arms, legs, body, or head. A drug or medication also might be used to restrict behavior or freedom of movement.
Why Seclusion and Restraint is Harmful
Studies have shown that the use of seclusion and restraint can result in psychological harm, physical injuries, and death to both the people subjected to and the staff applying these techniques. Injury rates to staff in mental health settings that use seclusion and restraint have been found to be higher than injuries sustained by workers in high-risk industries. Restraints can be harmful and often re-traumatizing for people, especially those who have trauma histories. Beyond the physical risks of injury and death, it has been found that people who experience seclusion and restraint remain in care longer and are more likely to be readmitted for care.
Eliminating Seclusion and Restraint
SAMHSA is committed to reducing and ultimately eliminating the use of seclusion and restraint practices in organizations and systems serving people with mental and/or substance use disorders. SAMHSA’s goal is to create coercion and violence-free treatment environments governed by a philosophy of recovery, resiliency, and wellness. Successful efforts have eliminated these practices in psychiatric hospitals, forensic psychiatric settings, therapeutic schools, residential treatment centers, and jails and criminal justice settings.
SAMHSA Programs and Initiatives
SAMHSA’s addresses trauma and promotes trauma-informed care through the following programs and initiatives:
- Interagency Task Force on Trauma-Informed Care
- National Child Traumatic Stress Initiative (NCTSI)
- Resiliency in Communities After Stress and Trauma (Project ReCAST)
- Cooperative Agreements for School-Based Trauma-Informed Support Services (TISS) and Mental Health Care for Children and Youth
SAMHSA expects all grant recipients to use funds to implement high quality programs, practices, and policies that incorporate Trauma-informed Approaches. It is critical recipients promote the linkage to recovery and resilience for those individuals and families impacted by trauma.