Trauma-informed C-L Psychiatry: Reducing Healthcare Disparities Across the Lifespan

A majority of people experience at least one traumatic event during their lifetime, and for some this may transition into PTSD (1). When unaddressed, trauma greatly increases an individual’s risk for both mental and physical illness throughout the lifespan (2).

Trauma-informed care (TIC) provides an empathic, patient-centered approach to help engage and address patients who have a history of trauma with the goal of decreasing health disparities and improving health outcomes. It involves consideration of trauma and its impact at an individual level, challenging biases and stereotypes while striving to give patients control they may previously have not felt in other areas of their lives and avoiding retraumatization. Given the prevalence of trauma in patients with mental illness, CL psychiatrists should not only be familiar with TIC principles but also help educate our colleagues in other specialties about TIC.

In this presentation, we will introduce the concept and principles of trauma-informed care. We will explore applications for CL psychiatrists as well as address ways they can educate colleagues in other disciplines.

Dr. Nichols will introduce the concept of trauma-informed care as well as practical applications of TIC for the CL psychiatrist. Dr. Spada will utilize a case-based format to discuss the impact of adverse childhood experiences on social, medical, and psychiatric outcomes across the lifespan. She will focus on disparities amongst underrepresented groups as well as their prevention. Dr. Sachdeva will address trauma in women. She will discuss sexual trauma and intimate partner violence with focus on epidemiological considerations, clinical presentations, screening tools and guidance, adverse health effects across the lifespan, and role of CL psychiatrists. Dr. Fonseca will describe concepts of minority trauma, minority stress, and culturally sensitive approaches to trauma-informed care. They will engage the audience in an interactive exercise to examine cultural differences between the patient and clinician with the goal of addressing diversity, equity, and inclusion considerations. Dr. Dragonetti will emphasize the importance of recognizing and addressing medical trauma and review the many ways in which a trauma-informed approach can improve patients’ experiences of healthcare and overall health outcomes. Each speaker will take 15 minutes to present a brief didactic followed by an interactive case discussion. The final 15 minutes will be used for questions and group discussion.

References:
(1) Sachdeva, J. et al. Trauma Informed Care in the Obstetric Setting and Role of the Perinatal Psychiatrist: A Comprehensive Review of the Literature. JACLP 2022
(2) SAMHSA’s concept of trauma and guidance for a trauma informed approach: Substance abuse and mental health services Administration. Available from: https://store.samhsa.gov/shin/content/SMA14-4884/SMA14-4884.pdf; 2014