Trauma-Informed Practice
BC Mental Health and Substances Use Services (BCMHSUS) use trauma-informed practices for the safety of our patients and clients.
Trauma is often closely tied to substance use, mental illness, stigma, barriers to health care, and other challenges. Trauma-informed practice means recognizing this link. It also means making sure that people feel safe and are not re-traumatized by their care.
Trauma-informed practice at BCMHSUS
We recognize the strong link between trauma, mental illness and substance use challenges. Most patients and clients of BC Mental Health and Substance Use Services have experienced more than one traumatic event.
We also recognize the broader effects of trauma. It can trigger reactions such as self-harm or aggression that may make someone's health challenges worse. These reactions may also deepen stigma, create barriers to health care and employment, and contribute to conflict with the law.
Considering this, we have implemented trauma-informed practice principles across the organization. Our leaders, physicians, and clinical and support staff are aware of the effects of trauma, and work to avoid re-traumatization. Our goal is to make sure that all our clients and patients feel safe and supported.
We also advocate for using trauma-informed practice principles in mental health and substance use treatment programs across British Columbia.
Trauma-informed practice resources
We follow trauma-informed practice principles as defined by the Substance Use and Mental Health Services Administration (SAMHSA), known as the Four R's:
- An organization-wide realization, or understanding, of how trauma affects people
- The ability to recognize the signs of trauma
- A system-wide response to trauma that informs all behaviours, language, programs, and policies
- Resisting re-traumatization of patients, clients and staff. Organizations can unintentionally create conditions that will re-traumatize people
You can find out more in SAMHSA's trauma-informed practice manual. We also use and recommend resources from the Government of BC and the BC Provincial Mental Health and Substance Use Planning Council.
Guides and studies
Our approach to care
Our approach to trauma-informed mental health and substance use care is much broader than individual treatment options. When interacting with clients and patients, our health care team works to provide a strengths-based, safe place for growth and healing. The focus is on recovery and resilience, regardless of the type of trauma a person has experienced.
This trauma-informed approach extends to all our programs, including:
- Forensic Psychiatric Hospital
- θəqiʔ ɫəwʔənəq leləm’ (Red Fish Healing Centre for Mental Health and Addiction)
- Heartwood Centre for Women
- Correctional Health Services and others
Our approach to trauma-informed practice is guided by six principles:
- Safety
- Trust and transparency
- Peer support
- Collaboration and mutuality
- Empowerment, voice and choice
- The importance of cultural, historical and gender issues
This approach allows clients and patients to be more engaged in their care.
Our practice goals
We have the following goals around trauma-informed practice.
- Increase awareness among health care providers and clients across the province of the prevalence of trauma. We want to increase awareness of the impact trauma has on mental and physical health and substance use
- Increase knowledge of trauma-informed principles and practice among all mental health professionals within our programs, PHSA and other health authorities
- Increase capacity among our mental health practitioners to better serve people affected by violence and trauma. This will improve outcomes for patients, clients and families
- Create safer environments for patients, clients, staff and physicians. We enhance physical safety in care settings and interpersonal safety in all interactions
- Give patients and clients choices and opportunities to collaborate. We want them to make safe connections with other patients and clients, staff, physicians, loved ones and community members
- Empower patients and clients. We recognize their strengths, foster their resilience, and believe in their recovery
We also provide leadership for a trauma-informed practice approach for other health care professionals in BC.
Examples of trauma-informed practice in our programs
We recognize many Indigenous patients and clients struggle with historical and intergenerational trauma.
All PHSA staff take part in San'yas Indigenous Cultural Safety Training. This training helps them provide culturally safe care to Indigenous patients and clients.
We follow trauma-informed policies and procedures to make sure clients and patients feel safe. We also do this to avoid re-traumatization. For example, we use the least restraint necessary at the Forensic Psychiatric Hospital.
When clients at θəqiʔ ɫəwʔənəq leləm’ (the Red Fish Healing Centre) or the Heartwood Centre return from a day pass, we only search their belongings. We do not subject them to a full-body search.
We help clients at θəqiʔ ɫəwʔənəq leləm’ (the Red Fish Healing Centre) or the Heartwood Centre identify triggers and situations that may cause them to react. We offer them a resource called the Calm, Cool, Collected Tool. This tool identifies positive coping strategies for them to use during their treatment.
During their stay, we help many clients create comfort plans. These plans help them recognize and respond to distressing situations. We also create comfort kits for clients. These kits, which include personal items such as essential oils, toys or a blanket, help a client feel grounded.
Patients at the Forensic Psychiatric Hospital may visit the comfort room when they are feeling triggered or upset. The room’s calming environment helps patients feel more relaxed, safe and secure.
We incorporated trauma-informed practice in every aspect of the θəqiʔ ɫəwʔənəq leləm’ (Red Fish Healing Centre) building design.
For example:
- All client bedrooms are private single rooms with ensuite bathrooms
- Clients can control the natural light and temperature in their rooms
- We chose furniture, fixtures, textures and colours designed to provide a calm, healing environment
- Exam rooms, counselling rooms, admission areas and other spaces have two ways of entering and leaving
We learn from other organizations who are doing this work well. We share trauma-informed practice tips in staff and physician newsletters.