Provider and Consumer Perceptions of Trauma Informed Practices and Services for Substance Use and Mental Health Problems

Both trauma-informed practices and trauma-specific services have been developed to meet the needs of individuals seeking services for mental health and substance use disorders. These approaches involve an acknowledgement of an individual's inter-related experiences of trauma, mental health, and substance use problems in all aspects of service delivery, and focus on enhancing consumer safety and control. Although trauma-informed practices and trauma-specific interventions have been repeatedly identified as critical to service provision in this area, there is little understanding of how these practices and interventions are delivered and experienced from the perspectives of service users and providers. The purpose of this study was to explore facilitators and barriers in implementing trauma-informed practices and delivering trauma-specific services in mental health and addiction service settings through qualitative interviews with service providers, consumers and research experts. Based on thematic analysis of in-depth interviews with 19 participants (including service providers, research experts and consumers), a number of key facilitators and challenges to implementation of trauma-informed practices and services emerged. Key facilitators included: organizational support, community partnerships, staff awareness of trauma, a safe environment, peer support, the quality of consumer-provider relationships, consumer and provider readiness to change, and staff supports. Challenges included: provider reluctance to address trauma, lack of accessible services, limited funding for programs/services, and staff burnout. Key areas of change identified in the study point to the need for increased intersectoral collaboration and support, greater system-wide trauma awareness and provider training in order to enhance the ability of trauma-informed practices and -specific services to meet the complex needs of this population.