Exposure to different types of psychological trauma may lead to a range of adverse effects on trauma survivors, including poor mental and physical health, economic, social, and cognitive functioning outcomes. Trauma-informed (TI) approaches to care are defined as a service system grounded in and directed by an understanding of how trauma affects the survivors’ neurological, biological, physiological, and social development. TI service system involves training of all staff, service improvements and sometimes screening for trauma experiences. The UK started incorporating TI approaches into the National Health Service. While policies recommend it, the evidence base for TI approaches to health care is not well established. We aim to conduct a systematic review to synthesise evidence on TI approaches in primary and community mental health care globally.
Methods and analysis
We will undertake a systematic search for primary studies in Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Cochrane library, websites of organisations involved in the development and implementation of TI approaches in health care, and databases of thesis and dissertation. Included studies will be in English published between 1990 and February 2020. Two reviewers will independently perform study selection with data extraction and quality appraisal undertaken by one reviewer and checked for accuracy by a second reviewer. A results-based convergent synthesis will be conducted where quantitative (narratively) and qualitative (thematically) evidence will be analysed separately and then integrated using another method of synthesis. We set up a trauma survivor group and a professional group to consult throughout this review.
Ethics and dissemination
There is no requirement for ethical approval for this systematic review as no empirical data will be collected. The findings will be disseminated through a peer-reviewed publication, scientific and practitioner conferences, and policy briefings targeted at local and national policy makers.
Funding This study is funded by the NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol. Grant reference number R100514-105. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
1Centre for Academic Primary Care, Population Health Sciences, University of Bristol, Bristol, UK 2Centre for Academic Primary Care, Population Health Sciences, National Institute for Health Research Applied Research Collaboration West (ARC West), Bristol, UK 3Centre for Academic Primary Care, Population Health Sciences, National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK 4Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK Acknowledgements We would like to thank Mike Bell (BRC PPI coordinator) for supporting us with the set up and coordination of study advisory groups and our survivor and professional advisory group for their contribution in identifying outcomes for this systematic review.This research was supported by the National Institute for Health Research (NIHR) (17/63/125) using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the authors and not necessarily those of the NIHR or the UK government.
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