In addition, they suffer disproportionate rates of physical illnesses (diabetes, HIV/AIDS, hepatitis, severe respiratory illnesses) and mental health disturbances (depression, posttraumatic stress, drug and alcohol addiction, suicide) (Kirmayer, 2014). The papers in this Journal of Traumatic Stress special issue on disproportionate adversity cover the gamut Culturally competent care for LGBTQIA+ youth of discrimination traumas and stressors, including microaggressions, a more insidious forms of discrimination, and their often‐devastating and wide‐ranging mental health sequelae, in disproportionately affected disenfranchised groups. The approach addresses traumatic experiences and facilitates healing in a safe and transparent environment that fosters community and peer support. Intentionally designing and establishing interprofessional groups (eg, members of chaplaincy, occupational and physical health, nursing leadership, psychiatry, psychology, and social services) to provide support to staff who might have been affected by a traumatic event can help to mitigate compassion fatigue, burnout, and secondary traumatization.21 There is a growing recognition about the effects of traumatic experiences on mental health worldwide. Addressing how cultural barriers to mental healthcare use can be overcome, Dr. Kim noted that “in practice, we need to have a two-pronged approach to address disparities in mental health for minority groups.”

Advances in evidence-based clinical practice have been effective in reducing symptoms and the disruptions caused by trauma (Hanson et al., 2018). Existing frameworks for addressing trauma mostly draw on research in psychology, psychiatry, social work, and nursing that informs clinical practice and clinical medicine (Champine, Matlin, Strambler, & Tebes, 2018; Galea & Vaughan, 2018; Hanson et al., 2018; Orkin et al., 2017). Thus, a resilience perspective indicates that trauma exposure can have not only costs but benefits to individual and population health.

Social Work Advocacy: Towards a Trauma-Informed Model

The implementation of TIC involves a vital cultural shift, where changes must occur across settings, disciplines, and service users, at all levels of an organization 16,17,18,19. Thus, there is a significant need for programs or frameworks that aim to change how the helping professions work with trauma and prevent victimization. These reactions may be exacerbated if they themselves have experienced trauma in the past, such as interpersonal violence. In psychiatric populations, the prevalence is much higher, and many (between 75 and 98%) report multiple traumas mentioned before . Trauma may occur because of a harmful incident or series of events that are emotionally disturbing or life-threatening, such as violence, neglect, abuse, disaster, serious illness, or historical injustice. A higher level of agreement on how to operationalize and implement TIC in international research could be important in order to better examine its impact and broaden the approach.

• Research suggests that it is NOT the objective severity of the trauma, but how it is experienced by the child or parent that determines traumatic stress responses.
• Thinking outside of the box to meet community members where they are is critical to build and leverage a groundswell of support.
• One of the most egregious of these experiences in recent history was the Indian Residential Schools (IRSs), wherein several generations of Indigenous children were forcefully removed from their homes and communities, and were subjected to maltreatment and abuse by residential school staff.
• The health of a population increases when interventions are undertaken to benefit everyone even if they do not necessarily benefit specific persons in their lifetime (Keyes & Galea, 2016), a phenomenon known as the prevention paradox (Rose, 1981).

Broad Considerations for Building Capacity and Engaging Communities in Trauma-Informed Change

Resilience may be developed as well as exercised and may occur at the individual- and community-level. All of these conditions and experiences demand contextual consideration in addressing community change. Such examples may include experiencing discrimination or racism, being bullied, experiencing migration or displacement, witnessing war, enduring or extreme poverty, being exposed to community violence or deteriorating built environments, or becoming involved in the foster system (Philadelphia ACE Project, n.d.; Posakony, 2020).

(eds) Trauma-Informed Healthcare Approaches. People can also advocate for themselves by assertively communicating their needs and seeking support when necessary. When people cannot access urgent, high quality care, their chances of survival decrease significantly. A 2020 study review found that people not fluent in English struggled to explain their symptoms or understand discharge instructions. (eds) Trauma-Informed Reproductive Healthcare. It is also incumbent on providers to recognize our own implicit biases and the way they impact our treatment of racialized patients who seek our care.

Providers using this model ask open-ended questions such as, “Have you had any life experiences that you feel have impacted your health and well-being?”. This approach avoids a one-size-fits-all perspective, instead emphasizing cultural humility. In intersectional trauma-informed care, patient assessment goes beyond the basics by incorporating factors like race, ethnicity, culture, nationality, and socioeconomic background. With nearly 40% of Americans identifying as part of racial or ethnic minority groups, these models aim to address the gaps left by standard care approaches. This gap limits the ability to fully integrate community-specific resources and perspectives into the care process. For example, research on Salvadoran women exposed to trauma found that 19 out of 20 women did not meet DSM criteria for PTSD, despite experiencing severe impairment and distress.