What does trauma-informed care mean to people admitted to a forensic mental health and intellectual disability service? A reflexive thematic analysis

Abstract

Objective: driven by research demonstrating the pervasiveness of trauma, forensic mental health (FMH) and intellectual disability services are increasingly adopting a trauma-informed approach to caring for patients. However, there has been limited attention to exploring what trauma-informed care (TIC) means to patients in these settings and what practices enable or restrict them in adapting positively after experiences of trauma. This study aimed to understand how TIC is conceptualized by people admitted to an FM Hand intellectual disability service. 

Method: focus groups were facilitated with 10 people residing in three low-secure units in the South East of the United Kingdom. Focus groups explored participants’ perceptions and experiences of TIC with reference to the guiding principles of safety, trustworthiness, choice, collaboration, and empowerment. Audio recordings of the focus groups were transcribed and analyzed using reflexive thematic analysis. 

Results: three themes were generated to capture participants’ perceptions that a trauma-informed approach in an FMH and intellectual disability service should entail promoting a sense of safety, fostering a sense of belonging, and encouraging the development of an autonomous identity.

Conclusions: the findings indicate that prioritizing social–interpersonal relationships is crucial to providing care that enables people admitted to FMH and intellectual disability services to adapt positively after experiences of trauma. The findings support previous research regarding recovery in secure services, indicating the value of creating sufficiently safe conditions for people to connect with others and develop a positive and independent sense of self.

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