The Need for Trauma-Informed Care

The emergency department (ED) can be a difficult environment for a person experiencing distressing emotions and feelings.

Finding it difficult to trust staff and feeling unsafe within the ED when it seems no-one is listening to them or taking their concerns seriously were common experiences among the people we talked to. It can be distressing when decisions are made about a person’s treatment and care without staff seeking their input. Conversely, it can help a person to feel safe, supported, and empowered when staff try to work together with them to understand what is happening and provide support that addresses their needs.

People with past experiences of trauma talked about possibly appearing to respond differently to staff and the environment compared with other patients. Distressing prior experiences within mental healthcare and ED settings can have a significant impact. Trauma responses can be easily triggered within the ED and quickly exacerbate the distress a person might be experiencing. They might be concerned about the gender of staff members involved in their care or worried about being isolated or restrained. This can be a particular concern for people who have experiences of sexual assault or being restricted or isolated. Asking about and taking a person’s concerns into account can help them to trust staff and reduce the potential for conflict.

Key points

• The ED can be a difficult environment for someone who is experiencing difficult feelings, thoughts, and emotions.
• A person’s history of trauma may shape how they respond to staff and available treatment. This may include their past experiences of mental health treatment or visits to an emergency department.
• Trauma informed practice can help to facilitate choice, collaboration and empowerment in mental healthcare. It can help to promote safety, build trust, and improve experiences of mental healthcare.