Mental Health Nursing: Trauma-Informed Care and Practice

This document discusses the principles of trauma-informed care and practice in mental health nursing. It explores the issues faced by patients and provides insights on collaborating with the multidisciplinary team. The document also explains how to apply trauma-informed care principles for positive outcomes.

Mental Health- Nursing

Table of Contents
Issues demonstrated in the video...........................................................................................................2
Principles of trauma-informed care and practice...................................................................................2
The principles of trauma-informed care practice are as follows:...........................................................3
Collaborating mental health nurses........................................................................................................4
Applying trauma-informed care principles............................................................................................6
Choosing another member of the mental health multidisciplinary team................................................6
References.............................................................................................................................................8
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Issues demonstrated in the video
Lisa was appeared to be in good health but with a poor level of grooming and personal care.
The issues that were being faced by Lisa are as follows:
 Lisa was restless and agitated, playing with her hair and moving in her chair during
the appointment. In the session, she seems to be distracted and respond to some
unseen voices. However, she was cooperative and communicated freely. She
appeared to be anxious and agitated (YouTube, 2011).
 Lisa depicted signs of delusional and paranoid thinking. It was believed by her that
people were spying on her with microphones and cameras in her home. She started to
sleep in the garden shed due to this reason. She also thought that a transmitted is
inserted in her stomach by her boyfriend when she was sleeping. She believes that her
boyfriend will harm her and she always has to protect herself by keeping a knife while
she sleeps under the garden shed. There was no history of violence in their
relationship and her boyfriend also does not have to harm anyone. Lisa has also did
not have a history of harming others or self-harm (Berlatsky, 2016).
 Lisa was experiencing some auditory hallucinations. Different horrible voices were
also being heard by heard. She also misplaced the medications that she takes and also
did not remember when the last tablets were taken by her. Her parents were giving the
medications and it was being found that Lisa was suffering from mental illness
(Duckworth, 2009).
Principles of trauma-informed care and practice
Trauma-informed care and practice (TICP) are considered to be a strengths-based framework
which is based on six core principles. The principles are safety, transparency and
trustworthiness, mutual self-help and peer support, mutuality and collaboration, voice, choice
and empowerment and gender, historical and cultural issues. Trauma-informed care and
practice will be used for treating Lisa as it do not harm, embrace a message of optimism and
hope that recovery can be possible. Lisa is being suffering from mental illness because of
some auditory hallucinations. Trauma-Informed care and practice will assist to understand the
dynamics and framework of traumatic stress of Lisa (Conover, Sharp & Salerno, 2015).
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The healthcare staffs play a significant role in assisting Lisa to overcome the health issue. It
is being found that trauma-informed care and practice decreases the symptoms, improves the
daily routine of the patient and decreases the use of crisis intervention and hospitalization. It
ensures successful collaboration with all the stakeholders, improved morale of the staffs,
enhanced skills, fewer negative circumstances, a greater sense of self-efficacy and more
positive outcome and effective services (Sunderland, 2019). It ensures the creation of an
emotionally and physically safe environment, establishing boundaries and trust, supports
choice and autonomy and creates participation opportunities and collaborative relationships.
The principles of trauma-informed care and practice should be applied while providing
mental health care services to Lisa in order to achieve positive outcomes.
The principles of trauma-informed care and practice are as follows:
Safety: Emotional, physical, cultural and spiritual safety is considered to be very much
important for Lisa while carrying out the trauma-informed care and practice. The first step
would be ensuring safety in order to develop trustworthy and strong relationships. The
healthcare staffs need to be aware of the vicarious trauma, self-care and traumatic stress.
Transparency and trustworthiness: The organizational frameworks and operations need to be
carried out with transparency. The main objective is to develop and maintain trust among
staffs, family members and clients those who are receiving services. It is very much
important to provide accurate and full information about what is happening and what will
happen in future to Lisa. The preparation and depiction of appropriate documents will assist
to provide adequate care to Lisa. The mental healthcare professionals should discuss the
health issue of Lisa with each other and also with her family members.
Mutual self-help and peer support: It is considered to be the integral aspect of the service
delivery and organization approach. The staff members should assist each other while
carrying out healthcare service process with Lisa. It is the key vehicle to build trust,
empowerment and ensure safety. There should be an appropriate understanding between the
healthcare staffs while providing care to Lisa (Trenoweth, 2014).
Mutuality and collaboration: Trauma-informed services provide opportunities to work
collaboratively with people of different cultures, ages and genders. An opportunity is being
provided within the service parameters that are being provided. It is considered to be an
experience of collaboration, connection and choice which includes examining the services
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and developing it as per the needs of Lisa. Within an organization, there should be meaning
sharing of decision making and power. Each and everyone play a significant role in the
process of trauma-informed care and practice.
Voice, choice and empowerment: The strengths of Lisa should be recognized, validated,
valued and new skills need to be developed. The aim of the organizations would be to
strengthen the experience of the clients, family members and staffs. It should be taken into
account that the experience of every person is unique and need an individualized approach
(Muskett, 2013). It consists of belief in resilience and abilities of organizations, communities
and individuals to promote recovery and health from trauma. Coping skills and promoting
resiliency can assist individuals to manage triggers associated with the past experiences of the
trauma as well as supporting self-advocacy and healing. A strength-based approach for the
service delivery can assist to recognize the resilience and abilities of Lisa, supports the
culture and social learning and foster empowerment.
Gender, historical and cultural issues: The organizations move actively the past cultural
biases and stereotypes, leverages the healing values of the cultural connections, provides
gender-responsive services and determines and addresses trauma.
Collaborating mental health nurses
Mood and affect of Lisa are congruent. She remains worried all the time and also presents
herself as fearful. She depicted signs of paranoid and delusional thinking and believe that
cameras in the houses are spying on him. She also believes that her boyfriend has placed a
transmitter in her stomach and always hears derogatory voices (Eby & Brown, 2009). The
voices also command her that she should protect herself from her boyfriend. She sleeps by
keeping a knife and it can be assumed that her boyfriend can be at risk. However, Lisa
accepted that she was experiencing such kind of troubles and agreed to be examined at the
local mental health service (Grice & Meehan, 2016). At the Mental Health Service, the duty
officer informed the concerns about the mental health situation of Lisa to the AOD
counsellor. An appointment at the afternoon was also being appointed which will allow the
counsellor to carry out the mental health care service.
The AOD counsellor would ask Lisa about her current mental health situation and also like to
ask whether her family member or carer can be contacted to assist her during the caring
process. The nurses should work closely with Lisa in order to understand the main reason
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behind the occurrence of the mental health issue and how it can be solved (Happell, Palmer &
Tennent, 2010). The information about the mental health issues faced by Lisa can be used for
developing an appropriate treatment care plan. The mental health nurses should carry out the
following common duties:
 Examining the mental health needs of Lisa
 Developing appropriate treatment plans
 Providing effective psychotherapy services
 Providing effective personal care
 Coordinating with doctors, families and other health professionals
 Administering medications
The nurses and other healthcare professionals should coordinate their process in order to
ensure effective caring provided to the patients. The information and data have been collected
regarding the current mental situation of Lisa and the reasons behind it. The focus would be
given on responding effectively to the mental health disorder of Lisa. The recovery
approaches can be applicable to life-changing conditions for Lisa (Isobel & Edwards, 2016).
Recovery-oriented practice is based on respect and dignity of Lisa, recognizing the
possibilities of wellness and recovery, maximizing self-management and self-determination
of the mental health and assisting the family to support and understand Lisa. The approach
will assist to determine and evaluate the expectations of Lisa and applying the most
appropriate technique. Medication is considered to be the most important technique to deal
with the situation (Provencher & Keyes, 2011).
The steps that can be followed for providing adequate care to Lisa are as follows:
 Providing care on the basis of continuous healing relationships.
 Providing customization on the basis of patient values and needs.
 Viewing the patient as the source of control.
 Collaboration means free information flow and sharing knowledge.
 Continuously focusing on cultural values.
 Using evidence-based decision making
 Promoting cooperation among nurses
 Recognizing the needs for transparency
 Anticipating and meeting the needs of the patient
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The understanding of the mental health issue of Lisa is considered to be very much important
for the nurses. Daily activities need to be taken into account in order to ensure that Lisa
should stay healthy. Therapies need to be suggested to Lisa in order to overcome self-doubt
and regain self-esteem. The principles of recovery can be applied to promoting the overall
wellbeing of Lisa (Levin, Hennessy & Petrila, 2010). Collaboration is important in order to
understand the values, attitudes and beliefs of the patient. The boyfriend of Lisa should also
be examined in order to understand why Lisa came to this situation. The needs of the patient
will help to coordinate all the processes in an appropriate manner. Both mental and physical
well being should be concentrated by the healthcare professionals. Medication and therapies
need to be provided to Lisa in order to overcome her mental health illness.
Applying trauma-informed care and practice principles
Trauma-Informed care and practice principles need to be taken into account while providing
care to Lisa. Safety is considered to be important which means that Lisa should feel safe from
both psychologically and physically. Lisa should not be afraid of which is necessary to
develop a trustworthy and strong relationship. It will allow the nurses to establish appropriate
communication and understand her mental illness (Ghafoori, Garfin, Ramírez & Khoo,
2019). Trust should be there between the nurse and Lisa in order to exchange information and
motives. Both nurses and Lisa should be transparent to each other about the facts and
processes. Healthcare professionals should work collaboratively in order to ensure a positive
outcome. The identification of individuals with similar traumatic experiences can assist to
develop trust, create safety, enhance collaboration and promotes healing and recovery. The
determination of strengths and differences in Lisa can assist to develop the foundation for
healing and recovery (Espejo, 2012). Lisa should be provided with the opportunity to
participate in the recovery process and taking her own decisions. The nurse should also
recognize any gender, historical and cultural issues. The principles can assist to provide
adequate care to Lisa.
Choosing another member of the mental health multidisciplinary team
The nurses can collaborate their caring process with the psychiatrists in order to manage the
mental health condition of Lisa. The psychiatrist will employ effective treatment such as
social medications and interventions and talking therapies in order to manage the mental
health problems (Engdahl, 2010). The psychiatrist will also be aware of the current situation
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or the problems that are being faced by Lisa. The nurses can carry out their work by taking
advice from the psychiatrist because he or she would expertise in the assessment of risk and
problems. The healthcare professionals should take into all the factors and circumstances in
order to achieve a positive outcome.
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References
Berlatsky, N. (2016). Mental illness (5th ed.). Farmington Hills, Mich.: Greenhaven Press, A
part of Gale, Cengage Learning.
Conover, K., Sharp, C., & Salerno, A. (2015). Integrating Trauma-Informed Care Principles
in Behavioral Health Service Organizations. Psychiatric Services, 66(9), 1004-1004. doi:
10.1176/appi.ps.201400526
Duckworth, K. (2009). Health (4th ed.). London: Evans.
Eby, L., & Brown, N. (2009). Mental health nursing care (6th ed.). Upper Saddle River, N.J.:
Pearson/Prentice Hall.
Engdahl, S. (2010). Mental health (5th ed.). Farmington Hills, MI: Greenhaven Press/Gale
Cengage Learning.
Espejo, R. (2012). Mental illness (4th ed.). Detroit: Greenhaven Press.
Ghafoori, B., Garfin, D., Ramírez, J., & Khoo, S. (2019). Predictors of treatment initiation,
completion, and selection among youth offered trauma-informed care. Psychological
Trauma: Theory, Research, Practice, And Policy. doi: 10.1037/tra0000460
Grice, T., & Meehan, A. (2016). Nursing (3rd ed.). Oxford [etc.]: Oxford University Press.
Happell, B., Palmer, C., & Tennent, R. (2010). Mental Health Nurse Incentive Program:
Contributing to positive client outcomes. International Journal Of Mental Health
Nursing, 19(5), 331-339. doi: 10.1111/j.1447-0349.2010.00679.x
Isobel, S., & Edwards, C. (2016). Using trauma informed care as a nursing model of care in
an acute inpatient mental health unit: A practice development process. International
Journal Of Mental Health Nursing, 26(1), 88-94. doi: 10.1111/inm.12236
Levin, B., Hennessy, K., & Petrila, J. (2010). Mental Health Services (3rd ed.). Oxford:
Oxford University Press, USA.
Muskett, C. (2013). Trauma-informed care in inpatient mental health settings: A review of
the literature. International Journal Of Mental Health Nursing, 23(1), 51-59. doi:
10.1111/inm.12012
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Provencher, H., & Keyes, C. (2011). Complete mental health recovery: bridging mental
illness with positive mental health. Journal Of Public Mental Health, 10(1), 57-69. doi:
10.1108/17465721111134556
Sunderland, M. (2019). Trauma-informed practice. Seced, 2019(7), 10-10. doi:
10.12968/sece.2019.7.10
Trenoweth, S. (2014). Mental Health Nursing (6th ed.). London: Churchill Livingstone.
YouTube. (2011). Understanding the MSE - Lisa (w/- commentary). Retrieved from
https://www.youtube.com/watch?v=83i2MWMqph8
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