“The steps to understanding”: Embedding trauma informed care into an inpatient mental health unit

Miss Deborah  Hewson1, Mrs Mary  Rayner1, Professor  Ken Walsh2

1Tasmanian Health Service, Hobart, Australia, 2University of Tasmania , Hobart , Australia

Background and rationale: Trauma informed care is an organisational structure and treatment framework aimed to understand, recognise, and respond to the effects of all types of trauma. It emphasises physical, psychological and emotional safety for both consumers and providers, helping consumers rebuild a sense of control and empowerment. Mistral place, a 10 bed sub-acute mental health unit in Hobart, where staff identified a need to develop more effective processes for working with trauma, undertook a project to bring a model of trauma informed care into practice.

Methods: An engagement plan was developed using the Building Effective Engagement Techniques (BEET) tool. Training in Trauma-Informed Care and Practice was rolled out to 90% of staff including domestic support, administration, allied health and nursing staff.  Low risk ethics was obtained and focus groups were organised to explore staff claims, concerns and issues regarding embedding the trauma informed care model into the unit. The Trauma-Informed Care and Practice Organisational Toolkit (TICPOT) was completed in collaboration with team members, external managers and consumer consultants to respond to its seven organisational domains and develop an action plan for implementing sustainable change.

Results: The application of the BEET tool, initial training and the claims, concerns and issues raised at focus groups facilitated in-depth understanding of the strengths of the service and challenges to overcome, and set the scene for embedding changes into more effective practice. The TICPOT highlighted specific areas of attention such as developing further policy and education, opening spaces for the introduction of more collaborative consumer and family work, and gave rise to strategies for improving direct client care.

Implications for practice: Changes are incremental but the process of engagement, exploration of strengths and challenges enabled work towards sustainable practice change across the service. Ongoing implementation of strategies and evaluation is planned over 2018.


Debbie has been working as an Occupational therapist for more than a decade. She is a specialist in mental health, early psychosis and Occupational Therapy and has worked as an OT across the globe, in the UK, Canada, and Australia.

She currently works in Inpatient mental health with the Tasmanian Health Service.

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