Trauma and Mental Health - Subtopic: Traumatic Stress

Transforming services to become “trauma-informed.”

The Issue

One of every two adults report having at least one experience of trauma.1 This involves an overwhelming event out of the realm of everyday experience, a physical or emotional threat, a sense of vulnerability, or loss of control. People are left feeling helpless and fearful. Trauma can affect every aspect of life--the ability to form and sustain healthy relationships, make decisions, maintain physical and mental health, and retain housing and employment.

Homelessness itself is traumatic. The loss of stability, home, community, safety, friends, and routines are not typical experiences. For many, the stress of homelessness is compounded by past traumatic experiences of illness, violence, combat, abrupt separations, or physical and sexual abuse.

Some people who experience trauma develop post-traumatic stress disorder (PTSD) with symptoms that may include re-experiencing the traumatic event, hyperarousal, and avoiding reminders of the experience. PTSD is more common among veterans, mothers who are homeless, and young people who are homeless.

Shaping the Solution

To facilitate recovery, providers should understand how to work with people who have experienced trauma. Human service agencies should become “trauma-informed” at the provider, program, and systems levels.

At minimum, services and systems should be designed to “do no harm” by avoiding further trauma. At best, programs and services should incorporate a full understanding of trauma and its impact on the physical and emotional health, cognitive skills, and relationships of trauma survivors.

1Kessler, RC, Sonnega, A., Bromet, E., Hughes, M. & Nelson, CB. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry. 52: 1948-2060.

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Trauma-informed care happens at multiple levels:

  • Providers: Adapt strengths-based approach that recognizes people’s abilities and knowledge. Understand and avoid an individual’s “triggers.” Believe in recovery.
  • Programmatic: Train providers to understand the impact of trauma on people’s lives. Create safe, welcoming environments. Ensure that services are culturally competent.
  • Systems: Recognize that problems and symptoms are interrelated and require well-coordinated care. Minimize hierarchies and share decision-making whenever possible.
Traumatic Stress - Trauma and Mental Health - Issues
Traumatic Stress, Trauma, issues
One of every two adults report having at least one experience of trauma. This involves an overwhelming experience, a physical or emotional threat, a sense of vulnerability, or loss of control. People are left feeling helpless and fearful. Trauma can affect every aspect of life--the ability to form and sustain healthy relationships, make decisions, maintain physical and mental health, and retain housing and employment.