A young woman went to the emergency room presenting with symptoms of psychosis – she was hearing voices and becoming more paranoid. She was in the beginning stages of psychosis so she could still recognize these thoughts and voices to be irrational and strange. She was deeply fearful of telling the emergency room staff about the voices. What if they thought she was crazy? What if they locked her up?
The young woman meets with the triage nurse who asks what brings her to the emergency room. Reluctantly, she shares her experiences of psychosis. The nurse pauses and then proceeds to ask a litany of clarifying questions: “When did you first hear the voices? Are they audible? Do they tell you to harm yourself? How often do you hear these voices?” The young woman becomes overwhelmed and begins to shut down, giving one-word answers and looking down. After the barrage of questions the nurse simply says, “Please take a seat in the waiting room, we’ll call you when we’re ready.” The young woman gets up and, instead of going to the waiting room, leaves the hospital.
You might think, but the nurse didn’t do anything overtly “wrong.” Technically, he did his job. He asked the necessary questions and triaged her presenting concern. The problem was the lack of connection. When people come to helping professionals for support as students, patients, clients, etc. they are inherently put in a vulnerable position: I am struggling and I am dependent on you to help me. When helping professionals prioritize efficiency over connection, people suffer. They feel like a task to be completed, instead of a person to be heard. Connecting with people, a core tenet of being trauma-informed, is even more important than getting the logistical tasks of our job done.
The young woman went home from the hospital, not receiving the help she needed, and further destabilized into psychosis. The delusions and hallucinations became indistinguishable from reality. Propelled by the relentless messages she was hearing, she attempted to take her own life. This is a true story. Sometimes she survives, sometimes she doesn’t. People live out this reality in our healthcare, education, and social systems. They come to us, entrusting us with incredibly vulnerable stories and experiences and, sometimes, they aren’t met with care and compassion. We don’t create the relational safety that people need in the midst of their suffering. This can lead to people falling through the cracks, psychological harm, and even loss of life.
Let’s try again. The young woman meets with the triage nurse who asks what brings her to the emergency room. Reluctantly, she shares her experiences of psychosis. The nurse pauses and then proceeds by saying, “Thank you for sharing this with me. It must be hard to talk about. I think it’s really brave you came in for help today.” The nurse does ask the necessary questions to assess risk and triage her accordingly, but he does it with warmth and kindness. He collaborates with her, listens to her, and reassures her throughout the conversation. He explains what the process will look like to ease any uncertainty and confusion. He practices in a trauma-informed way. This time, the young woman doesn’t leave the hospital because she has found some safety in the midst of a terrifying situation.
This is the why behind Trauma-Informed Care. People feel heard instead of silenced, safe instead of fearful, valued instead of discounted, dignity instead of disregard. Trauma-Informed Care protects people when they are at their most vulnerable. This is why Oaks teaches and promotes Trauma-Informed Care as a universal standard of practice. Find opportunities to learn more about Trauma-Informed Care here.