An update on the South Carolina trauma initiative.

Seven years ago the South Carolina Department of Mental Health developed a statewide effort to improve its response to consumers who are trauma survivors. The initiative's goals included sensitizing stakeholders to the impact of trauma, influencing policies, educating and training clinicians, addressing concerns about the safety and dignity of psychiatric settings (for example, sanctuary trauma), and increasing knowledge by supporting a strong empirical research platform. In the brief report presented here, the authors describe the past seven years in terms of obstacles encountered, progress, and future directions of this initiative in the hope of providing information and guidance to other state systems.

Patients' reports of traumatic or harmful experiences within the psychiatric setting.

Objective: This study examined the frequency and associated distress of potentially traumatic or harmful experiences occurring within psychiatric settings among persons with severe mental illness who were served by a public-sector mental health system.

Methods: Participants were 142 randomly selected adult psychiatric patients who were recruited through a day hospital program. Participants completed a battery of self-report measures to assess traumatic and harmful events that occurred during the course of their mental health care, lifetime trauma exposure, and symptoms of posttraumatic stress disorder.

The need for trauma assessment and related clinical services in a state-funded mental health system.

Previous data show that trauma is highly prevalent in public sector consumers and is associated with severe mental illness and high service use costs. Despite this, evidence suggests that trauma victims tend to go unrecognized and to receive inadequate mental health services. We surveyed all facilities (6 inpatient, 17 outpatient) within the South Carolina Department of Mental Health about their current services for trauma victims.