Helping the NHS to adopt new approaches to mental health care

Mental health care needs a radical shift to move away from treating the symptoms of physical and emotional abuse to understand the root cause of trauma. Northumbria’s Digital Health and Wellbeing research group within the Department of Computer and Information Sciences worked with one of the largest NHS Foundation Trusts to understand the main principles of Trauma-Informed Care, and how to embed this new approach to mental health care services. As a result of this collaboration, the NHS partners produced a novel commissioning framework for Trauma-Informed Care distributed with clinicians across the UK and created several online tools for NHS staff and service users.   

Trauma-Informed Care (TIC) is a framework for health care delivery that is based on insight of how trauma impacts people’s lives and their needs, aiming to facilitate recovery without re-traumatisation. The approach is relatively new to the UK and embedding TIC within large organisations such as the NHS is challenging. Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV), a UK pioneer in the adoption of TIC, used Northumbria’s research into complex system modelling in their implementation strategy.  

In 2019 Northumbria’s Associate Professor Petia Sice collaborated with the National Trauma Informed Community of Action Lead Dr Angela Kennedy and other partners to organise two summits with clinicians from across the UK who use trauma-informed approaches in their work. Drawing on the expertise of practitioners and people with lived experience of trauma, the team distilled seven main principles of providing TIC services, including such principles as compassionate and transformational leadership, responsive system design, and empowerment, among others. For example, a feeling of powerlessness is a key aspect of traumatisation. Designing empowering services means that individuals are supported in gaining a sense of control over their lives to help healing and recovery. These seven principles formed the basis for the first in the UK Commissioning Framework for Trauma-Informed Care. The TIC framework was incorporated into the NHS Long Term Plan for England.  

To start incorporating TIC into the work of the service, Northumbria’s Digital Health and Wellbeing research group’s member Garry Elvin helped the National Trauma Informed Community of Action and the Regional Staff Wellbeing Hub to develop several digital tools that could be used with staff and service users. One of these instruments is a Consensus Tool that is used by the NHS partners to explore challenging questions and investigate how to reach consensus in cases where divergent opinions exist. Feeding into the TIC principles of responsive system and compassionate leadership, the Consensus Tool was used during the webinar and focused on inequality and discrimination to understand where the community’s values and beliefs lie, so that decision-makers take the right direction in their work.  

During the COVID-19 pandemic, Northumbria’s DH&W team has developed another digital tool called Wellbeing Diary as an intervention designed to help NHS staff and service users cope with prolonged periods of isolation during the lockdown. The Culture, Health and Wellbeing Alliance highlighted that the Wellbeing Diary is one of the best examples of how creativity and culture can support vulnerable people at home during the pandemic.