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IHS Takes Steps Towards Becoming a Trauma-Informed Care Organization

by Tamara James, PhD, Acting Deputy Director, IHS Division of Behavioral Health

Trauma refers to experiences that can cause intense physical and psychological stress reactions. It can refer to a single event, multiple events, or a set of circumstances experienced by an individual as physically and emotionally harmful or threatening and can have lasting adverse effects on the individual’s physical, social, emotional, and spiritual well-being.

A trauma-informed care organization is one that emphasizes physical, psychological and emotional safety for both patients and providers, and helps survivors of trauma rebuild a sense of control and empowerment. 

In May 2020, IHS released the Chapter 37 Trauma-Informed Care policy in the Indian Health Manual. This fall, the policy was updated to reflect training requirements and guidance that will support IHS efforts toward becoming a trauma-informed organization that is patient-focused and driven, recovery oriented, integrates cultural humility, and provides trauma-informed services. Trauma-informed care supports the IHS Strategic Goal 2, Objective 2.2, by providing care to better meet the health care needs of American Indian and Alaska Native communities. 

The Trauma-Informed Care policy requires all IHS employees, including contractors, and volunteers to complete training annually on the impact of trauma, including historical trauma, on American Indian and Alaska Native people.

IHS works to implement the principles of trauma-informed care to ensure employees understand the prevalence and impact of trauma, facilitate healing, avoid re-traumatization, and focus on strength and resilience. This policy requires each facility to examine the health care environment and current policies and practices to incorporate trauma-informed care approaches throughout all programs and services.

IHS still has work to do and in the past year IHS has formed a multidisciplinary workgroup comprised of subject matter experts representing all IHS Areas to understand agency readiness and identify resources that will support implementation. An advantage of a trauma-informed health care delivery system is the emphasis on the physical, psychological and emotional safety for both patients and providers, and that it helps all trauma survivors rebuild a sense of control and empowerment.

Transforming into a trauma-informed care organization requires understanding the importance of recognizing the consequences of childhood trauma, including historical trauma, to comprehensively and effectively address the root causes of violence, suicide, depression, anxiety, self-harm, and chronic physical diseases. Through a trauma-informed approach, IHS aims to ensure safe, supportive, welcoming, non-punitive, respectful, healthy and healing environments for patients and staff. For updates on IHS trauma informed care efforts, please visit the IHS website.

Tamara James, PhD, Acting Deputy Director, IHS Division of Behavioral Health

Tamara James, PhD, is the acting deputy director and health science administrator for the IHS Division of Behavioral Health. She received her Doctor of Philosophy in biomedical sciences from New York University School of Medicine and her postdoctoral training includes the National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health and Human Development and a bioinformatic startup, Genecentrix, Inc. She is a member of the Choctaw Nation of Oklahoma.