Research estimates that between 50-60 percent of U.S. adults have experienced some type of traumatic event at least once in their lives and greater than 33 percent of youths exposed to community violence will experience PTSD as a result.

Trauma may include emotional, sexual or physical abuse, violence, neglect, discrimination, poverty, or other adverse events that are experienced by an individual as physically or emotionally harmful or life threatening. 1 Exposure to trauma increases the risk of negative health outcomes including substance abuse, chronic illnesses like heart disease and cancer, post-traumatic stress disorder (PTSD), depression, and other behavioral health problems.

“I realized that from an early age, many of my patients were exposed to trauma and adverse childhood experiences,” explains Dr. Cruz in the Center for Health Care Strategies’ What is Informed Care? video. “Some of my patients had multiple health issues, were uneasy during office visits, and frequently visited the emergency department. But worst of all, they never got better, despite multiple visits.” Dr. Cruz may be an animated physician, yet she is wise regarding how trauma impacts people’s mental, physical, social, and emotional well-being.

Trauma also places a heavy burden on health systems by lowering patient engagement, resulting in poor adherence to treatment, the overutilization of services and increased medical costs. Health care providers and systems are developing ways to make their services more responsive to individuals who have experienced trauma.

  • The Substance Abuse and Mental Health Services Administration (SAMSHA) recommends a system-level trauma-informed approach. An organization that has implemented a trauma-informed approach is one that realizes the widespread impact of trauma, understands possible paths of recovery, recognizes the signs and symptoms of exposure to trauma, actively avoids re-traumatization, and integrates knowledge about trauma into system-level policies, procedures, and practices.
  • The Center for Health Care Strategies (CHCS) has compiled key organizational and clinical ingredients for creating a trauma-informed approach to care. At an organizational level, they recommend engaging patients in organizational planning, training clinical and non-clinical staff members, creating a safe environment, and preventing secondary traumatic stress in staff.
  • CHCS’ Trauma-Informed Care Implementation Resource Center provides a wide array of resources for healthcare systems that are implementing trauma-informed approaches as part of high-quality health care that improves patient engagement, health outcomes, and lowers health care costs.

The Labor Management Project (LMP) has modified its foundational Patient-Centered Care (PCC) training to include information and role-plays for trauma-informed care. Participants have shown great interest in additional training to help deepen understanding and encourage implementation of specific practices and policies.


1 For information and citations, please contact Erick Rojas at Erick.Rojas@labormanagementproject.org

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