Toward a Trauma-Informed System of Care in Hawai'i's Adult Mental Health Division.
Year: 2015
Type: article
Abstract: Traumatic life experiences play an important role in the etiology of such severe and persistent mental illnesses (SPMI) as schizophrenia, bipolar, and major depression.1 Posttraumatic stress disorder (PTSD) and other trauma-related conditions are known to be highly prevalent among individuals diagnosed with SPMI. Moreover, traumatic life events have been consistently shown to worsen an individual's prognosis with respect to the severity and treatment of SPMI symptoms. At the national level, epidemiological studies have estimated that between 70% and 98% of adults presenting SPMI also present a co-occurring history of trauma.2 In Hawai‘i, a 2009 survey of 175 consumers of state adult mental health services in Honolulu County found that 89% of the sample reported at least one traumatic life event and 32% screened positive for a history of PTSD.3 Aside from the prevalence data, there is substantial clinical evidence linking PTSD and trauma histories with higher rates of SPMI symptom relapse, comorbid substance use disorder symptomatology, and utilization of more costly mental health treatment services, such as inpatient care and emergency hospitalization.4,5 Studies also have noted those with SPMI are at a greater risk to experience traumatic life events and become more debilitated by their effects.6,7
When taken together, research on the prevalence of traumatic life experiences among individuals with SPMI has prompted several states to secure federal planning and implementation grant awards that aid mental health services transformation toward a trauma-informed system of care. In particular, the Substance Abuse and Mental Health Services Administration (SAMHSA) has funded separate Hawai‘i State Department of Health (DOH) initiatives to address the impact of traumatic life experiences on the child and adult populations DOH serves. As described in a previous article published in the Hawai‘i Journal of Medicine and Public Health,8 Project Kealahou began in 2010 in an effort to establish a trauma-informed system of care within DOH's Child and Adolescent Mental Health Division. In 2011, the Adult Mental Health Division's (AMHD) Trauma-Informed Care Initiative (TIC-IT) began, and AMHD has since made significant progress toward establishing itself as a trauma-informed system of care. This article provides a brief overview of AMHD's TIC-IT.
Source: Europe PMC (PubMed Central)
Authors: Michael J Endres, Stefan Keller, Steven Y C Wong, Karen Krahn
Institution: Hawaii Department of Health
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W805133356