HJNO Mar/Apr 2024

Q&A 22 MAR / APR 2024 I  HEALTHCARE JOURNAL OF NEW ORLEANS   maybe they didn't have that at first. Avoidance is a huge thing, but also stigma, potentially in the community, of accessing mental health services is another reason why it's helpful that we're in the hospital on the inpatient side. We're embedded in the medi- cal team, whereas a mental health clinic in the community is more isolated. Someone would have to seek it out and be willing to go to amental health clinic. Here, our clinic is in the building with all the other medical clin- ics. It may seemmore palatable to someone who is hesitant to get mental health services. How far has the practice of trauma recovery management come, and what were the leading drivers to that change? Nationally, we're seeing more aware- ness of trauma, the prevalence of trauma, and more recognition around how various events impact individuals, groups, and orga- nizations. There are other trauma centers who are also doing this proactive screening to catch any trauma-related stress early on. Having that be a part of the routine trauma care in a trauma center is huge and definitely makes an impact. When it comes to trauma-informed care, that's an area that is growing, but maybe not fast enough. I wish we could see it growmore rapidly. Trauma-informed care is a frame- work developed out of SAMHSA [Substance Abuse andMental Health ServicesAdminis- tration] that basically describes how to run any organization such as a school, hospital, or system in a manner that recognizes the prevalence of trauma, responds to signs that someone has experienced trauma, and also actively resists retraumatizing the individu- als within that setting. This manifests in a lot of different ways, but it's ideally implemented from the top down in everything from pol- icy, procedures, marketing, physical envi- ronment. It's infused throughout a trauma- informed organization. I think there's some movement towards this. We do a lot of trauma-informed care train- ing here in different departments. My goal is form of an intervention, building a rapport with the patient and the family and assess- ing for any trauma-related distress; provid- ing some education about what that might look like; and encouraging the family and the patients to keep an eye out so that if and when something does come up, they can call and get connected with support so it doesn't get worse. We know that if there are unad- dressed trauma-related symptoms, it can lead to PTSD or co-occurring disorders like depression, which also can lead tomaladap- tive coping with substance use or alcohol use. We are trying to get ahead of all of that by meeting with patients early on in the hospital stay. Then, when they're discharged, they're already, hopefully, set up with an appoint- ment in the center, so they can continue get- ting our services and support to continue on their recovery process. I want to note that the center’s services are available not just to people who come to UMC. That's just one route that people can enter, and that's a common route. What are the biggest obstacles faced in getting a trauma victim to seek help? That's a good question. One of the primary symptoms of PTSD is avoidance, meaning avoiding thoughts, feelings, reminders of what happened. When you think about that, that's a huge barrier, because their gut instinct might be, “I don't want to talk about this at all. I don't want to think about it. I don't want to remember what happened.”So, coming to the Trauma Recovery Center that has trauma in the name is definitely not something that people with PTSD look forward to. That's one big barrier. But, part of the healing process is putting words to their experience so that they can heal. With a therapeutic environment and trust in our team, we see that people end up, when they do come, opening up and being able to tolerate facing what happened, and not only doing that, but makingmeaning out of the experience and finding hope in their future. When we saw them in the hospital, further injury, through casemanagement and helping people achieve their life goals. This is happening underneath the trauma recov- ery umbrella, whereas in other TRCs, it hap- pens adjacent — they work together, collab- oratively. The way we've designed it, we are collectively working towards our mission of healing trauma and reducing violence by breaking cycles of harm and creating path- ways for recovery in our community. Explain how your team is interrupting cycles of trauma. When someone comes into the emergency room with a traumatic injury, the violence interrupters, credible individuals who have been trained in trauma-informed care and are familiar with the issues faced by communi- ties with high levels of community violence, are there and ready to build a relationship with the family and the patient and to dees- calate tensions. Right there is an opportunity to affect change, to provide support, whereas often the focus of the emergency room is to keep someone alive, to focus on their physi- cal injury — which is, of course, critical — but having that other component can make a huge difference, especially early on in what happens next for that person's or the family’s emotional or psychological recovery process and how they cope with what's happened or what is happening. That's just for gunshot survivors. Beyond individuals’ hospital stay, trained violence intervention specialists work with survivors of gun violence to establish goals that are meant to reduce their risk of future violence. Through trauma-informed case management that emphasizes the wounded individuals’ own described per- sonal strengths, specialists can form a long- term relationship aimed at keeping them safe and further interrupting cycles of violence. For any trauma patient that comes into the hospital, we have the trauma recovery team on the inpatient side who goes to their bedside in the hospital, often in the trauma ICU or on the trauma floors, and meets with the patient. They'll do a screening in the