Skip to site content

Trauma Informed Care Provides Healing

by Chris Fore, Ph.D., Director, IHS TeleBehavioral Health Center of Excellence, Indian Health Service

Many American Indian/Alaska Native (AI/AN) communities experience, cope with, and recover from the effects of trauma on almost a daily basis. The data tells us that AI/ANs have the highest rates of trauma in the United States. From suicide, accidents, unintentional overdoses, substance use, health disparities, and poverty; the causes of trauma are numerous. Additionally, many AI/ANs cope with the effects of past traumas. Though these traumatic events may be years or decades old, we know they impact our current functioning and well-being. These cross-generational effects are known as Historical Trauma. Many AI/ANs face the dual hardship of Historical Trauma with multiple contemporary traumas stacked on top. This can often become a house of sadness, pain, and illness that is built on the suffering experienced by our ancestors.

Recent research shows that traumas, especially those experienced in childhood, can have profound effects across the lifespan. We know that the more Adverse Childhood Experiences a child has the more likely they will have health, behavioral health, relationship, and other challenges throughout life. When considered with Historical Trauma, these impacts are magnified.

Given this, it would be easy to despair and to be hopeless, but we are survivors. Native peoples are strong and resilient. Given the amount of trauma we experience, we have fewer symptoms and problems than predicted by the research. We also know that traditional practices and involvement with our culture provides protection from the effects of trauma. Traditions and culture often provide a path through the trauma to healing and wellness.

Trauma informed care can also provide healing. Trauma informed care is also a systematic approach to facilitating recovery from trauma. It is a system-wide framework that involves understanding, recognizing and responding to the effects of trauma. Trauma informed care emphasizes physical, psychological, cultural and emotional safety for everyone, including patients, staff, providers and communities.

To help fulfil the IHS mission “to raise the physical, mental, social, and spiritual health of AI/ANs to the highest level,” we are pleased to announce two trauma informed care initiatives.

The first project is the Pediatric Integrated Care Collaborative (PICC). This is a partnership with the Johns Hopkins Center for Mental Health Services in Pediatric Primary Care and the Johns Hopkins Center for American Indian Health, to increase the quality and accessibility of child trauma services by integrating behavior and physical health services in AI/AN communities.

The second is the Trauma Informed Care Education Project. In partnership with the University of New Mexico Center for Community Behavioral Health, this project is a broad-based educational program to train IHS staff in Trauma Informed Care, so that we provide a more comprehensive and understanding approach to our patients and communities as they deal with effects of current and past traumas.

Related Content:

IHS Explores Behavioral Health Aide Program Success in Anchorage

IHS Announces Pilot Program for Child Trauma-Informed Integrated Care

New Tribal Agenda Aims to Improve Behavioral Health in Native Communities Exit Disclaimer: You Are Leaving 

April is National Child Abuse Prevention Month

More information on these exciting new, patient-centered initiatives can be found at the new IHS Trauma Informed Care website at

Chris Fore, Ph.D., Director, IHS TeleBehavioral Health Center of Excellence, Indian Health Service
Dr. Fore is a member of the Choctaw Nation of Oklahoma. During his 18 year career with IHS, he has served at the Service Unit, Area, and Headquarters levels of the agency.