Institutional Responses to the Need for Trauma Informed Care

However, the conceptualization and implementation of trauma-informed service and system design within addiction and mental health settings are still in their infancy despite their relevance. Despite a number of promising advances, the discipline is still in its infancy in Canada. Similarly, anti-violence interventions that are trauma- and substance-informed are still in the early stages of development despite the vast spectrum of needs resulting from exposure to trauma (BC Society of Transition Houses, 2011).

As examples of promising new developments in emergent systemic approaches to mental health and substance use, we can look to the Centre for Addiction and Mental Health's (CAMH) practice model of care (Chan et al., n.d.) and the virtual National Center for Trauma-Informed Care, sponsored by the Substance Abuse and Mental Health Services Administration ([SAMHSA], 2011) in the United States. CAMH's approach for professional practice includes trauma-informed treatment as one of its cornerstones.

As an interesting corollary, the progress of understanding trauma-informed practice is mirrored by a corresponding change in how we react to homelessness. There is an underlying and implied xv xvi Becoming trauma informed is taking into account people's experiences with trauma while building programs to help those experiencing homelessness.

The homeless services sector has been a leader in trauma-informed practice in shelters, but there is still more to be done to mainstream trauma-informed care throughout the homeless services sector as a whole. According to Hopper et al. (2010), there is a lack of clarity around trauma-informed care implementation strategies, a dearth of exemplary programs, and a lack of coordination and cooperation among existing initiatives.

Few studies have looked at the effects and nature of trauma-informed care, hence there is a lack of descriptive and research literature in this field. There has to be more discussion on what constitutes trauma-informed care, what adjustments should be made within systems hoping to provide trauma-informed care, and how those changes should be implemented. (p. 81)