Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1A1.
Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1A1.
Health Policy. 2021 Jul;125(7):899-914. doi: 10.1016/j.healthpol.2021.04.008. Epub 2021 Apr 20.
Trauma is a hidden epidemic and a public health concern in Canada and globally. To address the pervasiveness of trauma in general and clinical populations, a trauma-informed approach (TIA) has been widely promoted in the field of mental health (MH). This study explores how a TIA has been incorporated in Canadian MH policies across all provinces and territories, and in both government and non-government organizations. A systematic mapping review in multiple search sites resulted in a total of 60 TIA policy documents in MH policies. The findings indicated that despite the broad range of the search period which went back as far as the 1980s, TIA policies started emerging in 2010 in the field of Canadian MH. Our research findings also showed an increased understanding of a broad definition and various types of trauma and an acknowledgement of its causes and impacts on multiple levels. This highlighted the importance of all levels of services in TIA. Through this search, we identified the widespread use of different terminologies to refer to TIA. This may create confusion about what TIA means in policy, research, and practice. We propose areas for improvement such as including experiences of marginalized populations, explicitly centering cultural and gender sensitive approaches in TIA policy initiatives, clarifying the standard definition of TIA and its implementation services, and establishing indicators and evaluation methods for future research and policy directions.
创伤是加拿大乃至全球的隐性流行病和公共卫生关注点。为了解决普遍存在的创伤问题，特别是在一般人群和临床人群中，一种创伤知情方法（TIA）已在心理健康领域得到广泛推广。本研究探讨了 TIA 在加拿大所有省份和地区的心理健康政策中，以及在政府和非政府组织中是如何被纳入的。在多个搜索站点进行的系统映射审查共产生了 60 份心理健康政策中的 TIA 政策文件。研究结果表明，尽管搜索范围广泛，追溯到 20 世纪 80 年代，但 TIA 政策在加拿大心理健康领域于 2010 年才开始出现。我们的研究结果还表明，对广泛的创伤定义和各种类型的创伤以及其在多个层面上的原因和影响有了更深入的理解。这强调了 TIA 在各级服务中的重要性。通过这次搜索，我们发现了广泛使用不同术语来指代 TIA。这可能会导致人们对 TIA 在政策、研究和实践中的含义感到困惑。我们提出了一些改进的领域，例如包括边缘化人群的经验，在 TIA 政策倡议中明确以文化和性别敏感的方法为中心，澄清 TIA 的标准定义及其实施服务，并为未来的研究和政策方向建立指标和评估方法。
