The implementation of trauma informed care in acute mental health inpatient units : a comparative study : a thesis presented in fulfilment of the requirements for the degree of Master of Public Health at Massey University, Wellington, New Zealand

Abstract

Trauma informed care (TIC); particularly related to interpersonal violence, is a burgeoning topic for mental health services in both New Zealand and Australia. This thesis compares the implementation of trauma informed care, particularly in relation to interpersonal violence, in an acute mental health inpatient unit in New Zealand and a similar unit in New South Wales, Australia. A policy analysis was undertaken of current policy documents that guide each unit, along with semistructured interviews with ten senior staff, five from each unit to investigate implementation of key features of trauma informed care, particularly in relation to interpersonal violence. Results showed a difference in overall implementation between the two units. Single interventions rather than a whole of service change of philosophy were evident. Differences were identified in relation to policies referring to interpersonal violence, staff knowledge and understanding of trauma informed care, access to training and resources, how safety was provided for, collaborative care arrangements and workplace power dynamics for both clients and staff. Across both units were identified a lack of guidance to inform implementation of TIC, consumer involvement and practice around diversity. Contributing factors for TIC implementation include having a clear definition of TIC, commitment at all governance levels, access to TIC training for all staff, and policies underpinned by TIC. Further research investigating these results may enhance service delivery, resulting in better outcomes for the promotion of recovery and healing of those with histories of interpersonal violence.