The pursuit of whole-person and whole-community health is a collective journey that demands that we create environments and systems that not only respond to mental and behavioral health challenges but also proactively support the development of resilience and well-being. This underscores the importance of comprehensive, trauma-informed policies and practices across all sectors and systems. It requires an ecosystem of care that removes barriers and actively integrates a variety of physical, emotional, intellectual, social, spiritual, occupational, environmental, and financial health resources, services, and supports.

 

As we move forward, it is crucial to continue advocating for and implementing trauma-informed changes that recognize and embrace the complexity and interconnectedness of all aspects of human health.

 

This dimension of the vision calls for us to:

• Engage in efforts to reframe the conversation around mental and behavioral health, moving away from stigma and shame towards narratives that recognize the impacts of trauma as well as the strength, resilience, and wisdom embedded in coping and survival strategies with which people with lived experience of trauma and adversity have engaged

• Increase equitable access to trauma-informed, high quality mental and behavioral health services, particularly in trauma-impacted communities

  • Create requirements for Medicaid and Medicare to reimburse trauma-specific interventions as well as culturally-sustaining and healing practices for all

  • Eliminate pathologizing and limiting practices within insurance reimbursement policies, such as the need for providers to present a formal diagnosis for services to be covered, as well as placing time limits on how many sessions are covered given the non-linear, highly contextual pathways to healing and recovery

  • Increase access to online mental health resources and therapy platforms

  • Fund opportunities for individuals with lived experience of trauma and adversity to attend and facilitate trauma-informed peer support groups

• Require comprehensive foundational and ongoing training on trauma and trauma-informed approaches among all of the workforce in the mental, behavioral, and physical health sectors

  • Increase training for assessing trauma and providing appropriate, non-retraumatizing referrals in mental, behavioral, and physical healthcare settings and systems

  • Ensure the workforce is equipped with training on the impacts of the work, including constructs such as vicarious trauma, burnout, compassion fatigue, and moral distress, as well as vicarious resilience, vicarious post-traumatic growth, compassion satisfaction, and moral courage

• Require all mental, behavioral, and physical healthcare settings to implement trauma-informed policies, practices, protocols, and resources to support a healthy, compassionate, trauma-responsive workforce

  • Make receiving public funding contingent upon providing a formal plan to promote trauma-informed practices organization-wide and have a centralized entity set minimum standards as well as review organizational plans

  • Create and fund requirements that community-based organizations and settings in significantly trauma-impacted areas employ a Chief Resilience Officer, Director of Workplace Well-Being, or other dedicated role to encourage providing meaningful structural supports as well as trauma-informed engagement with to the workforce

  • Encourage employers to offer programs supporting financial wellness and mental/behavioral health supports to employees

• Enact regulations to safeguard privacy and confidentiality in telehealth-based mental and behavioral health services and supports, while also ensuring care provided is aligned with ethics evidence-informed best practices for trauma recovery

• Adopt a harm reduction approach to addressing behavioral health and substance use

  • Reform laws to treat substance use as a public health issue rather than a criminal offense

  • Train providers on important structural components contributing to individual and group substance use challenges such as racism, poverty, oppression, stigmatization, and marginalization

  • Fund and pilot supervised consumption sites so individuals can use substances safely and access healthcare support if needed

  • Implement needle exchange programs, providing clean needles to reduce the risk of diseases

  • Prioritize using restorative justice practices over legal system involvement for people who are charged with non-violent offenses

  • Increase the use of diversion courts to reduce people with substance use challenges placed in carceral institutions

  • Expand access to medical-assisted treatment for opioid and other substance dependencies

  • Implement comprehensive education programs about the risks and safer practices of substance use, particularly given the influx of the presence of fentanyl in street drugs

  • Provide stable housing for people who use substances, without preconditions of sobriety or treatment participation

  • Integrate mental health services with substance use programs

• Establish and finance more mobile crisis response teams with trauma-informed training to address mental and behavioral health challenges in the community, independent of law enforcement involvement

• Enhance the 988 mental health emergency service operations to integrate a trauma-informed approach to reduce re-traumatization

  • Promote trauma-informed de-escalation and support safe solutions to reduce hospitalizations following 988 calls

  • Ensure all operators and responders have been trained in a trauma-informed approach

  • Ensure the staff reflects diverse backgrounds and is trained in cultural humility to effectively assist callers from all communities and backgrounds

  • Create systems for feedback from service users and their families to continually refine and improve the service

• Prioritize funding for organizations and systems of care that are dedicating time, energy, and resources to providing trauma-informed, trauma-responsive, and trauma-specific services and supports

• Increase participation and representation of diverse people with diverse lived experiences in the workforce

  • Pursue pathways for paid professional positions facilitating peer support groups 

  • Create and fund grant, scholarship, and fellowship programs to provide more pathways to educational opportunities and professional roles for trauma survivors within the mental, behavioral, and physical healthcare sectors

• Identify and address shortages in prevention and early intervention programs, especially in trauma-impacted communities and areas populated heavily by groups or populations that research demonstrates as being more likely to experience trauma

• Provide funding to support culturally-responsive education and support for pregnant people, including access to doula services, nutritional coaching, and other resources and services to promote healthy prenatal, perinatal, and postpartum experiences

• Enhance public transportation and infrastructure to expand access to healthcare and community resources

• Fund the development of community-based centers, green spaces, cultural programs, arts and other expressive activities, and other resources for social and physical activities as well as building community connections

• Establish a minimum standard for employers to require some mental health days in addition to sick and vacation time for part- and full-time employees

• Incorporate mental health considerations in responses to environmental crises, wide-scale disasters, and other experiences of collective trauma

• Reform child- and family-strengthening systems and entities to anchor more faithfully in the principles of a trauma-informed approach to support healthy, thriving, whole families

• Fund the development of resources that enhance awareness about addressing and preventing trauma as well as actionable steps individuals and communities can take to work together to reduce re-traumatization

• Create panels consisting of Create panels consisting of trauma survivors, mental health experts, and community leaders to inform policy development

• Engage the Interagency Task Force on Trauma-Informed Care to help develop recommendations for healthcare- and holistic wellness-related systems to implement, as well as to provide technical assistance to support trauma-informed change implementation

• Support research on trauma effects and resilience-building strategies

• Implement national curriculum changes to require including mental health education, social-emotional learning, and other allied topics from early childhood through high school settings

• Create public awareness campaigns to normalize and destigmatize experiences of trauma as well as mental/behavioral health challenges, as well as promote individual and collective healing-centered ways of engaging with others as well as resilience-building practices

  • Engage in initiatives to educate about the disproportionalities in mental health, especially concerning trauma exposure

  • Ensure affirming, trauma-informed messaging, particularly in campaigns targeted for communities and groups that have been impacted by trauma