Measuring trauma-informed care systems change to reduce seclusion & restraint

In an effort to reduce the rates of seclusion and restraint use within two of Connecticut's state psychiatric hospitals, the state mental health system has adopted Community Connection's model of trauma-informed systems change. Core to this approach are the concepts of safety, trustworthiness, choice, collaboration, and empowerment. To quantify the effects of integrating trauma-informed principles within both hospitals, staff and consumer rating scales were developed to tap into the ward climate and interpersonal atmosphere of the targeted units and to measure change in these areas, as reflected in consumer and staff attitudes and feelings. This presentation will describe the process of scale development and administration to the consumers on the affected wards. We will also compare findings from the first two observation waves (baseline and first post-test) with respect to each domain of trauma-informed care, and present information on scale validity and reliability. These findings will also be compared with reductions in violence on the wards, including seclusion, physical restraint, chemical restraint, and staff injury due to assault.