Understanding trauma in Older Adult mental health wards: A thematic analysis of staff perspectives

This service evaluation explored staff perspectives on trauma and trauma-informed care (TIC) within two older adult mental health wards - one organic ward and one functional mental health ward. A short, four-item questionnaire was developed to further investigate aspects of the Trauma-Informed Organisational Development Framework Toolkit: self and peer evaluation toolkit (HNY Health Care Partnership, n.d.), which was being used as part of a broader service evaluation of TIC. Responses from 25 participants were examined using Braun and Clarke’s (2006) six-phase process for thematic analysis. Key themes emerged around understandings of trauma as a subjective and enduring experience, the emotional and behavioural impact of trauma, the complexity of discussing trauma with older adults, and the perceived importance of adopting a trauma-informed approach in care delivery. Staff demonstrated strong awareness of TIC principles, particularly in relation to service users. However, there was limited reflection on staff wellbeing or the application of TIC to the workforce itself. These findings highlight both the existing strengths in staff awareness and the need for further exploration of the barriers to understanding that TIC includes staff and the organisation. It also demonstrates a need to strengthen broader organisational practices that support trauma-informed environments for both service users and those providing care. Future research could incorporate service user and expert-by-experience perspectives of the ward environments, and explore what additional trauma-informed practices might help staff from an organisational perspective