Guest article by Laura James, Improvement Service

“(If people were trained in trauma)… it would have made a huge difference at the start for me” – member of SafeLives Authentic Voice panel

Responding to psychological trauma is, now more than ever, a public health priority. COVID-19 and the restrictions put in place to contain the virus have significantly increased the risk of people experiencing trauma and re-traumatisation. The prevalence of trauma is already higher for people facing adversity, disadvantage and inequality and we know that the pandemic has exacerbated existing economic and social inequalities. Without access to high-quality support, people affected by trauma are at higher risk of experiencing poorer outcomes at all stages of their lives. Trauma can impact on outcomes across mental and physical health, education and employment, and we know that trauma and vicarious trauma can cause poor wellbeing, chronic stress and burnout across the workforce. There is growing evidence that embedding a trauma-informed approach in the re-mobilisation of services, systems and workforces can support Scotland’s long-term recovery and renewal from the pandemic.

Through the National Trauma Training Programme (NTTP), the shared ambition of the Scottish Government, COSLA and partners is to develop a trauma-informed and trauma-responsive workforce across Scotland. The aim of this work is to ensure we deliver services in ways that prevent further harm or re-traumatisation for those who have experienced psychological trauma or adversity at any stage in their lives and support their unique recovery journey.

A trauma-informed approach is made up of many different components, but at its heart is the recognition that everyone has a role to play in tackling the causes and impact of trauma, minimising barriers to accessing support, and in improving the outcomes of people affected by trauma. Not everyone in the workforce needs to be able to treat trauma, but it is vital that everyone has the knowledge, skills and confidence to respond to trauma appropriately and effectively. But learning also tells us that there are a number of key drivers that support training to be successfully translated into practice, including leadership that embodies the key principles of safety, trust, choice, control, collaboration and empowerment; prioritising staff wellbeing; collecting data and information about people’s experiences and embedding feedback loops; and valuing the contribution of people with lived experience of trauma.

At the Improvement Service (IS), we provide a range of support to local authorities and other key stakeholders to raise awareness of the benefits of a trauma-informed approach across systems, services and the workforce, and to strengthen the capacity and capability of councils and partners to implement a trauma-informed approach.

Trauma deep dive event series

In partnership with NHS Education for Scotland (NES) and Scottish Government, the IS recently facilitated a series of learning events over 2020-21 that explored how adopting a trauma-informed approach can support key community planning priorities. The events featured keynote speakers highlighting good practice and learning across a range of services/ organisations, including stakeholders from police, health, councils, and the third sector. There were a wide range of attendee roles, organisations, sectors, and a broad geographic spread from across Scotland. Learning resources from the events are available on our website.

Across all of the learning events, participants highlighted consistent themes as essential to supporting the implementation of a trauma-informed approach in services/ organisations, including:

  • Ensuring systems and services are informed by lived experience;
  • Strengthening awareness raising and multi-agency working at a national and local level;
  • Embedding a trauma-informed approach into practice and policy beyond workforce training;
  • Prioritising support for staff wellbeing; and
  • Buy-in for trauma-informed approaches from leaders locally and nationally.

The image below shows some examples of barriers and enablers to implementing trauma-informed practice and policy, as highlighted by participants across the series of learning events:

Further resources and information

The NTTP website provides information on the training and resources developed by the NTTP to support the skills and knowledge of the whole Scottish workforce. This includes access to e-learning modules, videos about the benefits of trauma-informed practice, and information on the Scottish Trauma-Informed Leaders Training programme (STILT). This interactive PDF summarises the key trauma training resources from the NTTP that are openly available to support all members of the Scottish workforce to strengthen their understanding of their role in responding to people affected by trauma.

The Trauma Informed Practice Toolkit for Scotland has been developed in collaboration with experts by experience and provides clear, tangible examples of where trauma-informed practice has been successfully embedded across different sectors of the workforce.

Community of practice

There is an online community of practice which is free and available to all professionals across Scotland who are interested in finding out more about trauma-informed policy and practice and who would like to share learning.

Resources to raise awareness of trauma-informed policy and practice

These publications highlight how adopting a trauma-informed approach to Scotland’s COVID-19 recovery, renewal and transformation agenda can support key priorities, including improving outcomes for vulnerable people and communities affected by trauma and supporting workforce wellbeing and resilience:

Trauma champions network

The IS is supporting the development of a network of trauma champions, who are senior leaders across local authorities, NHS Health Boards, Health and Social Care Partnerships and other key community planning partners. Through a collaborative action learning programme and 1-1 support, we are supporting champions to drive forward trauma-informed practice and policy across their organisations and local areas in a multi-agency, collaborative way.

Public pledge

The Scottish Government have developed a leadership pledge of support for organisations to pledge their ongoing commitment to embedding trauma-informed principles and practice in Scotland to support anyone affected by psychological trauma. You can find out more about the pledge and how your organisation can sign up here.

For more information about the Improvement Service’s work on trauma, please contact: trauma@improvementservice.org.uk