Johnson County considers trauma-informed care model

0 | Community Health, Corrections, Mental Health

— Spurred by success stories from across the country, Johnson County officials who work with troubled populations are exploring how their agencies might improve treatment by taking into account the often-traumatized personal histories of the people they serve.

Raul Almazar, a senior consultant with the federal Substance Abuse and Mental Health Services Administration, spoke Wednesday at the Johnson County Administration Building, describing various examples found nationwide of how “trauma-informed care” can help.

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Raul Almazar, a senior consultant with the federal Substance Abuse and Mental Health Services Administration, outlines the concept of trauma-informed care during a recent presentation in Olathe.

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Brought in by the Johnson County Trauma Informed Care Task Force, Almazar spoke to about 65 officials from various disciplines, including law enforcement, courts, mental health and domestic violence assistance.

“Trauma-informed care is not fancy,” Almazar said. “It’s just getting back to doing the right thing.”

Task force members would like the agencies to determine the amount of time, money and personnel each could devote to implementing trauma-informed care, said Valorie Carson, who is coordinating the task force in her role as community planning director for United Community Services of Johnson County.

Task force members said they hope to have an implementation plan ready by March.

Underlying the philosophy of trauma-informed care outlined in Almazar’s presentation is the premise that crime, drug use and other deviant behavior are often the byproduct of abuse, neglect, violence or other overwhelming personal experiences.

Supporters of trauma-informed care believe that by adopting practices that get at the personal histories, agencies can intervene more appropriately, reducing the need for restraint and seclusion and better protecting their staff workers.

The changes could involve relatively simple things such as encouraging more flexibility and understanding from staff.

Almazar gave these examples:

  • At a community mental health center in Kentucky, front-office staff removed the Plexiglas barrier that separated them from clients. They realized, he said, “it is not the Plexiglas that is keeping you safe; it is the connection that keeps you safe.”
  • A psychologist friend of his in Alaska encountered self-esteem issues in a girl who wondered why she was not getting molested like all the other girls she knew. “You have to understand the context in which you are practicing,” he said.
  • At an agency in Virginia that served developmentally disabled clients, staff members began offering a glass of water to individuals who became agitated, which helped calm them. The lesson learned, he said, was that comfort could work better than more physical controls.

Almazar also drew on his experience as a front-line nurse to explain how an agency can help staff members who encounter their own traumas and stress in their jobs.

His said his colleagues knew he became angry when a patient made fun of his accent.

If that happened, he said, the next thing he heard over the loudspeaker was, “Raul to the nurses’ station,” as his fellow employees removed him from a potentially combustible situation.

That was a poignant point for Carson.

“We can talk about having each other’s back,” she said, “but I’m not sure the majority of us are clearly aware of our own self-triggers.”

The Johnson County Sheriff’s Office already has embraced the idea of recognizing issues, such as mental illness, and referring individuals for treatment rather than booking them into jail, said Capt. Shawn Fletcher, a member of the task force.

Certain officers have been trained as crisis intervention specialists, he said, and they assist in situations where it appears that an inpatient mental health facility would be a better option than jail.

But Fletcher said trauma-informed care could increase staff understanding of a situation, such as recognizing the stress involved for a person being arrested for the first time.

“Maybe all it takes is for the officer who is going through the intake process with them just talking to them and explaining this is what’s going to happen to them,” he said.

The ultimate outcome of this work, Carson said, would be to develop a core local team that could provide training throughout the county, including in schools and hospitals.

That’s down the road, she said, because even establishing the practice in the task force agencies is sure to take time.

“It is nothing you are going to get done in a couple months,” she said.



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