Trauma is an all-too-common experience among jailed people, often shaping their behaviors, health outcomes, and interactions with authority figures. The impact of past trauma is compounded in correctional settings, where stress, isolation, and a lack of trust in authority can exacerbate mental and physical health challenges. That’s why trauma-informed care is critical in correctional environments. This post explains this type of care and its impact on incarcerated people.
What is Trauma-Informed Care?
Trauma-informed care is an approach to care in which the provider recognizes and understands the effects of trauma in a way that promotes healing and avoids re-traumatization. It shifts the focus from “What’s wrong with you?” to “What happened to you?” This perspective acknowledges that past traumatic experiences can shape a person’s behavior, health outcomes, and engagement with others, including care providers.
Trauma-informed care is built on these key principles:
- Safety. Safety is critical, and the provider’s goal is to ensure physical and emotional safety for patients, reducing the risk of re-traumatization.
- Trust and Transparency. Honesty and open communication between providers and patients is essential to positive care outcomes.
- Peer Support. Recognizing the importance of support in healing and encouraging support networks that help people cope with trauma.
- Collaboration and Mutuality. Reducing power imbalances between healthcare providers and patients, fostering shared decision-making.
- Empowerment and Choice. Understanding that trauma often takes away choice, and one way to re-establish it is by helping people regain control over their health and treatment plans.
- Cultural Sensitivity. Acknowledging and addressing patients’ diverse backgrounds and experiences, and how they may create unique traumatic concerns and triggers.
By recognizing the widespread impact of trauma and responding with care, this approach fosters a safer, more supportive environment for patients.
Benefits of trauma-informed care include:
- Improved Health Outcomes. This type of care helps people manage conditions, reduce stress, and engage more actively in their health. It also supports long-term emotional well-being by addressing trauma-related mental health concerns.
- Stronger Relationships. Trauma-informed care fosters trust between providers and patients, improving communication and cooperation by helping people feel heard, respected, and valued.
- Enhanced Emotional Regulation. People who receive trauma-informed support develop better coping mechanisms, reducing impulsive or harmful behaviors. This type of care helps people process and heal from past trauma rather than being trapped in reactive patterns.
- Reduces Violence and Conflict. Trauma often manifests in aggression. By addressing root causes, this type of care reduces fear and associated aggression.
- Stops Trauma Cycles. Trauma is often passed from one generation to the next. Trauma-informed care disrupts the cycle of generational trauma by providing intervention and supportive care.
Overall, people who experience emotional trauma feel out of control of their situations and, many times, their responses to trauma triggers. When care providers demonstrate understanding of trauma and its responses, and help patients develop the same understanding, they help reestablish patients’ autonomy, which Dr. Alicia Irvin, TK Health’s Director of Psychological Services, said is beneficial in a jail environment.
“Helping patients feel autonomy in relation to their care is especially important in situations such as incarceration, when much of their daily life is out of their control.”
Trauma Exposure and Its Potential Outcomes
Trauma is a death or near-death experience or exposure to an extreme stressor. It can be a single incident, repeated exposure to harmful experiences, or prolonged adversity.
Traumatic experiences can include:
- Child abuse or neglect
- Physical or verbal abuse
- Sexual assault or rape
- Grief or loss of a loved one
- Car wrecks or other accidents
- Natural disasters
- Racism or other discrimination
- Bullying
- Witnessing a crime, death, or near-death experience
- Military or combat experiences
- Home insecurity or homelessness
Everyone is exposed to traumatic happenings in their lives. Many people are able to process the emotions surrounding those events and, with time, adjust to life after the trauma. Others cannot.
Emotional trauma is a psychological, emotional, and physiological response to a traumatic event. When a person can’t cope with or emotionally process the happening, they experience emotional trauma that affects how they perceive the world, process emotions, and respond to stress.
Symptoms of emotional trauma include:
- Dissociation or feeling disconnected from your body or surroundings
- Fear for safety, even when it’s unnecessary
- Being on edge or hypervigilant
- Having flashbacks of the traumatic event
- Being easily startled
- Aggression, anxiety, and/or depression
- Changes in sleep and eating patterns
- Body and/or head aches or just not feeling well
- Gastrointestinal issues
Understanding Trauma in Incarcerated Populations
Trauma exposure is common in the lives of jailed people. Research consistently shows that incarcerated populations experience trauma at significantly higher rates than the general public, making them more prone to the emotional impacts. One study found that 95% of incarcerated people have experienced at least one traumatic event.
Trauma in Early Life
Many jailed people were exposed to trauma in childhood, making the associated emotions even more difficult to process. These adverse childhood experiences (ACEs) can leave a lasting impression and continue creating mental health concerns into adulthood.
More than 60% of adults experience at least one ACE, according to the Centers for Disease Control. However, one study found that 98% of incarcerated people had experienced at least one ACE. The likelihood of experiencing traumatic fallout increases with the number of ACEs a child experiences.
Common Types of Trauma Experienced by Incarcerated People
Trauma can take many forms, and its effects are often cumulative. People’s response to trauma is also variable, with people responding in completely different ways to the same traumatic happening. It’s all about how people can process what happened to them and make sense of it.
Common traumatic experiences among incarcerated populations include:
- Childhood Abuse and Neglect. Many jailed people grew up in environments where physical, emotional, or sexual abuse was common. These experiences can lead to difficulty trusting authority figures, regulating emotions, and forming healthy relationships.
- Community and Domestic Violence. Exposure to violence in neighborhoods or personal relationships can cause hypervigilance, aggression, and difficulty feeling safe.
- Systemic and Intergenerational Trauma. Discrimination, poverty, and historical oppression contribute to cycles of trauma that disproportionately affect marginalized communities.
- Substance Use-Related Trauma. Many incarcerated people have a history of substance use, which is often linked to self-medication for unresolved trauma.
The Impact of Trauma on Physical and Mental Health
Unresolved trauma has profound effects on physical and mental health, often leading to chronic conditions that require medical and psychological attention. Chronic stress from trauma contributes to high rates of heart disease, hypertension, chronic pain, and weakened immune function among incarcerated people.
One study found that 9.8% of jailed people have Post-Traumatic Stress Disorder, the most severe type of trauma disorder. Depression, anxiety, and self-harm also are common among jailed people. Many people with these conditions develop maladaptive coping mechanisms, such as substance use or aggression, which can worsen their health and make rehabilitation more challenging.
The Importance of Trauma-Informed Care in Correctional Healthcare
In correctional healthcare, trauma-informed care ensures that medical and mental health services are delivered with an awareness of trauma symptoms in jails how trauma affects incarcerated people. It requires providers to approach patients with sensitivity, avoid triggering past trauma, and create a safe and supportive environment for healing.
Benefits of trauma-informed care in correctional healthcare include:
- Improved Health Outcomes. Addressing trauma reduces the risk of chronic health conditions, improves mental well-being, and increases treatment adherence.
- Reduced Behavioral Incidents. People who feel safe and respected are less likely to engage in aggression, self-harm, or disruptive behavior.
- Better Relationships. Trust-based care leads to more engagement in medical and mental health treatment.
- Lower Recidivism Rates. Addressing underlying trauma helps incarcerated people develop coping skills that contribute to successful reintegration into society.
What Does Trauma-Informed Care Look Like in Practice?
Trauma-informed care shapes every interaction between healthcare providers and patients. This approach helps healthcare teams recognize how past experiences can influence a person’s physical and mental health, as well as behavior.
In correctional healthcare, trauma-informed care can be applied in many ways, including:
- Building Trust. Healthcare providers explain procedures, answer questions, and communicate clearly so patients understand what to expect. Open, respectful communication can help reduce anxiety and foster trust.
- Treating Patients with Dignity and Respect. Every person deserves compassion, regardless of their circumstances. Using respectful language and actively listening to patients can help create a better experience for the patient.
- Recognizing Trauma Responses. Patients who have experienced trauma may appear withdrawn, anxious, angry, or reluctant to engage in care. Instead of assuming these behaviors are intentional or disruptive, providers can consider whether they may be trauma-related.
- Promoting Collaboration. Trauma-informed care encourages providers to involve patients in decisions about their healthcare whenever appropriate. Explaining treatment options and encouraging questions can help patients feel more autonomous and engaged in their care.
- Using De-Escalation Techniques. When a patient becomes distressed, healthcare providers can use calm communication and empathetic listening to help reduce the tension.
- Supporting Continuity of Care. Trauma-informed care starts with the healthcare team’s interactions with the patient and continues as the patient leaves the facility. The healthcare team should do their best to connect the patient with resources to continue care outside of the jail.
Dr. Irvin said practicing trauma-informed care is a worthwhile investment in people’s well-being beyond their time in jail.
“The warm handoff of services allows providers to bridge care and help to improve the odds that patients will continue their trauma-informed care on the outside.”
Implementing Trauma-Informed Care in Correctional Facilities
Implementing trauma-informed care in correctional facilities requires a shift in mindset, policies, and practices. Correctional caregivers must integrate these principles into daily healthcare operations to create a safer, more effective system of care.
Steps to implementing trauma-informed care include:
- Training Staff in Trauma Awareness. Healthcare providers, correctional officers, and administrators should be trained to recognize signs of trauma and respond with empathy and de-escalation techniques.
- Creating a Safe and Supportive Healthcare Environment. Minimizing triggers and using calming communication techniques helps create an environment conducive to healing.
- Integrating Mental Health Services. Mental health services are critical in prisons and jails because patients in these locations need these services on an even larger scale.
- Adopting Patient-Centered Approaches. Allowing people to have a voice in their treatment decisions and respecting their boundaries.
Trauma-Informed Care with TK Health
At TK Health, we understand the importance of trauma-informed care in re-establishing safety and autonomy among correctional patients, helping them heal. Learn more about the services we provide and contact us to learn more or to work with us.
FAQs
Why is trauma-informed care important in correctional healthcare?
Many patients entering jail have experienced trauma before incarceration. Trauma-informed care helps healthcare providers recognize how these experiences may affect a patient’s overall health and behavior, thereby altering their approach to patients and improving health outcomes.
Does trauma-informed care compromise safety or security?
No. Trauma-informed care doesn’t change the security requirements of a correctional facility or excuse inappropriate behavior. Instead, it complements existing safety protocols by helping healthcare providers communicate effectively, recognize trauma responses, and de-escalate situations when appropriate.
How can healthcare providers implement trauma-informed care?
Healthcare providers can incorporate trauma-informed care into everyday practice by:
- Involving patients in their care when appropriate
- Communicating respectfully
- Explaining medical procedures before performing them
- Protecting patient privacy whenever possible
- Recognizing signs of trauma
