I always stumble a little bit when I have to explain to someone what exactly we do. Sometimes it is difficult to put into words. There are a variety of services we provide but I have to say, there are two things that stand out to others when we get involved in their lives. One, our ability to provide support and assistance during a time of crisis (whether it be criminal or tragic, doesn’t matter). The other is our information. Specifically, information about trauma and being a victim and what that might mean for you either as a victim or a support person. The more you know about what is going on and happening and what to expect, the better able you are to deal with it (usually).
This often leads to conversations about what others have already said and let me tell you, it never ceases to amaze me how little trauma training that is mandatory for emergency and mental health services. You don’t know what you don’t know, but sometimes that can lead to saying things that are less than helpful to others. Trauma is a critical component that helps to shape and at times drive an individual’s behaviour and decisions and thoughts and can do so for quite some time after the fact and yet, for some reason, the post-secondary education and training programs don’t all see the need to include it as part of the over-all package. That doesn’t make sense. This can be surprisingly noticeable in some aspects of mental health.
I get that the relationship between trauma and mental health isn’t necessarily clear, largely because of how complex it is. Not everyone that has been abused or traumatized develops a mental health condition and not everyone struggling with a mental health challenge has experienced violence or abuse or trauma. But, the relationship exists and has been well established for quite some time.
I remember attending training at the traumatology institute and sitting beside a lady that worked with adult females struggling with addictions issues. In fact, I think (if I remember correctly), she worked within some form of residential treatment. Their statistics for their residence showed that over 90% of the adult female addicts that had stayed there had an abuse history with the vast majority of the violent experiences being sexual in nature.
While that alone doesn’t say much more than what happens in that particular residence, not surprisingly, research has reported that the rate of childhood abuse experienced by adult women struggling with mental illness is about 80% (inpatients who have been physically and / or sexually abused – Rajan, 2004). That is also really high.
Yet, even with this, when I worked in mental health, I received very little trauma training and typically only the training that I pursued was on my own.
The behaviour of someone who has been traumatized doesn’t always nicely fit into the current model for mental health intervention and treatment. Unless you’ve had specialized training in trauma, the behaviours are not well understood nor are they looked at in the framework of trauma, victimization and social and psychological stressors (poverty, substance abuse, violent home / neighbourhood). When symptoms are looked at in isolation from the rest of the person and their life, they are often approached in a singular – treatment until it fails model (at least that is what I call it). You know how that works, children and adult mental health function on the same premise; we’re going to direct you into a treatment stream until you fail at it and then we’ll look at another treatment stream until you have a whole series of failures underneath your belt and then we’re going to say there’s nothing we can do for you, we can’t help you or you’re not trying.
I’m sure that’s related to money and resources but what if, just for a minute, we looked at it differently.
What if we tailored the intervention to the individual’s needs. I know, I know, I’m talking crazy here but what if. And what if we not only tailored it to their needs, but we tailored it to all of their needs at once and provided them with a variety of services that they could move back and forth with as they needed. What if we didn’t wait for people to fail, we just opened all the doors and let them choose what was in their own best interest. And finally, what if we started to recognize that the social worker and the nurse and the police officer and the firefighter and the child and youth worker and the doctor should all understand trauma, neurobiology and victimization as it relates to their own fields. That way, behaviour that doesn’t make sense, just might.