Tina Smith presentation

Australian WFD and Learning Directions for Achieving Recovery OrientedTrauma Informed Services
Trauma Informed Care and Practice:
Meeting the Challenge Conference
Sydney - 23 & 24 June 2011
Tina Smith, Senior Policy Officer MHCC

Why Pursue WFD and Learning Directions?
We need to presume the clients we serve have a history of traumatic stress and assume universal precautions by creating systems that are “trauma informed”.
(Hodas, 2005)

Changing culture requires both ……
Organisational change
Workforce change
“Where will the staff with the rights skills and experience come from to deliver trauma informed services?”

Criteria for building a trauma informed MHS system (SAMHSA, 2007)
3/12 criteria relate to WF
WF recruitment, hiring and retention of trauma informed staff
WF orientation, training, support, job competencies and standards related to trauma
Consumer/trauma survivor involvement and trauma informed rights

Education and training systems …
Accredited (AQTF) Trauma? No
University qualifications
eg, GP, psychiatry, nursing, psychology, SW, OT
Vocational qualifications (CS&H Training Packages)
eg, Certificate IV and Diploma in MH and/or AOD, other?
MH Peer Worker Competency Development Project
Non-accreditedTrauma? Yes
Short courses

CS&HISC MH Skills Articulation Project
Methodology
VET/Universities & Mapping Reports
Explored MH qualifications and content at Australian universities
Policy and Workforce Report
Interviews and focus groups about job roles/tasks
79 MHWs (public/community, staff/managers)
Diverse qualifications and experience
3 areas (metro, regional, rural)

Practice and occupational boundaries in CMH

CS&HISC MH Skills Articulation Project
Findings (Policy and WF Study)
Supported integration across medical, talking and social rehabilitation approaches
Identified the need to:
“Systematically assess the skills and knowledge required to work effectively in the sector, with a view to developing a unified body of psychosocial practice from which to derive an evidence-based workforce strategy”
Filling gaps in knowledge & skills

Inclusion of Trauma in MH WFD Directions in Australia
Trauma? No
National MH Strategy, Plan, Standards
COAG NAP MH 2006-2011
National MH WFD Strategy/Plan
Health Workforce Australia (HWA)
Skills Australia
Trauma? Yes
CSHISC Environmental Scan 2011/CIP
As well as service coordination, PSR & talking therapies to improve responses to people with complex and diverse needs

CSHISC Environmental Scan 2011
“Examine expansion of care coordination roles and skills/practices to support increasingly complex needs, including trauma-informed care and talking therapies. Any development of training package content should be addressed in conjunction with broader community MH WFD objectives and identification of a unified body of knowledge/evidence about PSR/recovery-oriented practice”.
“This work would inform the existing 2010–2011 work plan proposal: ‘Mental health work – recovery-oriented community mental health and higher-level skills’”.
What are the competencies needed to deliver trauma informed services?

Trauma competencies
Competence - Definition
The state or quality of being adequately or well qualified; ability.
A specific range of skill, knowledge, or ability.
Knowledge- what we know
Skills- what we do
Attitude- how we do it

“Criteria for building a trauma informed MHS system” (SAMHSA, 2007)
3/12 criteria relate to WF
WF recruitment, hiring and retention of trauma informed staff
WF orientation, training, support, job competencies and standards related to trauma
Consumer/trauma survivor involvement and trauma informed rights

1. WF recruitment, hiring and retention of trauma informed staff
Prioritize staff with training in and/or lived experience of trauma (eg, job descriptions, “trauma champions”)
Outreach to trauma informed/educated employees
Advocate for trauma content in education and training
Incentives, bonuses and promotions for trauma informed staff
Professional development opportunities to become trauma informed
Trauma informed/protective OH&S

2. WF orientation, training, support, job competencies and standards related to trauma
Trauma informed HR for all employees
… that incorporates relevant skill sets and job standards
Broad human service involvement (ie, integration & coordination)
All staff (admin, direct care, management)
To receive basic education about …
Prevalence of trauma
Traumatic impacts
Dynamics of re-traumatization
Diversity and trauma

All direct care staff (clinical and non-clinical)
Understanding & responding to complex behaviour/s
Maintaining boundaries (personal & professional)
Trauma dynamics and the avoidance of iatrogenic re-traumatization
Relationships between trauma, MH and life problems
Vicarious traumatization and self-care
Specific traumas (issues & approaches)
Trauma techniques (eg, grounding, recovery skills)
And … all Training must involve
people with lives experience

All clinical staff (including disaster response staff)
Evidence based practice in trauma assessment & treatment skills
Participation on advanced trauma training
For disaster responders – initial assessment through intervention

3. Consumer/trauma survivor involvement and trauma informed rights
Involved at all levels of service planning, implementation & evaluation (ie, not just training and peer work roles)
Trauma informed ISPs developed collaboratively with every consumer and, where appropriate, their involved family and friends
Rights informed participation agenda (ie, discrimination)

Implementation plan for the 4th National MH Plan
Workforce Development
Action 25: Develop and commence implementation of a National Mental Health Workforce Strategy that defines standardized workforce competencies and roles in clinical, community and peer support areas.
Action 26: Increase consumer and carer employment in clinical and community support settings.

Trauma competencies
“Comorbidity Competencies Skills Indicators” (Graham, H. & White, R., 2011)
Essential Knowledge
Core Practice Skills
Specialist Skills/Leadership

Trauma competencies
Essential Knowledge
Knowledge of the impacts of a history of trauma and the various ways it can impact an individual, family and/or community
Basic knowledge of impact of childhood abuse and neglect and the links with adult problems.
Knows that trauma can be associated with complex and diverse health and social issues and unhelpful coping strategies (suicidality, intoxication/self-medication, dissociation, anxiety, excessive anger, self-harm).

Trauma competencies
Essential Knowledge
Identifies and responds to mental health issues immediately following a traumatic event, but does not try to engage with the trauma history at this time.
Is aware of triggers, vulnerabilities or untimely helping that might contribute to re-traumatisation.
Supports consumers who have been through trauma to access MH treatment, rehabilitation and support services, where indicated.

Trauma competencies
Essential Knowledge
Actively demonstrates a recovery oriented approach to understanding how trauma affects each individual, helping them to discover their own strategies and goals.
Collaborates with other health and community services professionals involved in the persons’s recovery from trauma.
Provides education for people seeking healthy coping strategies in response to trauma.
Facilitates professional development for services to be more trauma informed.

Supervision, coaching & mentorship
Professional development
Leadership
Trauma champions
Healing workplaces
Organizational/cultural change
Trauma informed approaches
are
Recovery oriented approaches

Recovery principles include
Hope and faith
Meaning, purpose & direction
Equality & respect
Empowerment & self-determination
Social inclusion and connectedness

Summation

Mental Health Coordinating Council
PO Box 668, Rozelle NSW 2039
Cnr. Church & Glover Streets, Callan Park
P: (02) 9555 8388 F: (02) 9810 8145
Email:info@mhcc.org.au Website: www.mhcc.org.au
Materials available online such as: information; fact sheets; training & workforce development; research publications; the Mental Health Rights Manual; submissions; sector events; current issues and news. www.mhcc.org.au
Presenter: Tina Smith tina@mhcc.org.au

Tina Smith presentation

by mhcc on Jul 27, 2011

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Tina Smith presentation — Presentation Transcript