Co-design a Trauma Informed Care Intervention In Inpatient Mental Health Settings For Adults: Intervention Development

Background: Trauma-informed care (TIC) is increasingly recognised as essential in inpatient mental health settings to prevent re-traumatisation, improve patient outcomes, and support healthcare professionals (HCPs). Current inpatient practices, such as restraint and seclusion, can exacerbate trauma and negatively impact both service users and clinicians. Despite existing guidelines, there is no universally agreed-upon approach for implementing TIC, and research highlights the need for interventions co-designed with service users, carers, and clinicians. This study aims to evaluate the effectiveness of TIC interventions and co-develop and deliver a TIC framework to enhance personal, interpersonal, and organisational outcomes in inpatient mental health settings. Methods: This 18-month study employs an Experience-Based Co-Design (EBCD) methodology, aligned with the MRC framework for developing and evaluating complex interventions. It consists of three work packages (WPs): (1) a systematic review to assess the effectiveness of existing TIC interventions, (2) qualitative experience-gathering through interviews with service users, informal carers, and clinicians, and (3) co-design workshops to develop an intervention tailored to diverse trauma experiences. The study will be guided by a Lived Experience Advisory Group (LEAG), comprising trauma survivors, family members, and clinicians, ensuring meaningful engagement at every stage. Results: WP1 will systematically review and synthesize evidence on TIC interventions in inpatient mental health services, identifying key barriers, facilitators, and outcomes at personal, interpersonal, and organizational levels. WP2 will conduct semi-structured interviews (20–25 service users and carers, 15–20 clinicians) to explore lived experiences of TIC implementation, potential challenges, and the need for tailored approaches. WP3 will use co-design workshops to collaboratively develop a TIC intervention, integrating findings from WP1 and WP2. These workshops will be facilitated by trauma specialists to ensure a safe, trauma-sensitive environment. Outputs will include a structured TIC intervention framework, co-designed training materials, and implementation strategies tailored to inpatient settings. Discussion: This study addresses a critical gap by developing an evidence-based, co-designed TIC intervention tailored to the complex needs of service users and clinicians. It emphasises trauma-sensitive practices to reduce re-traumatisation, enhance clinician well-being, and improve healthcare service delivery. The intervention will be informed by service users experiences and clinical expertise, ensuring cultural and contextual relevance. Findings will inform NHS mental health services, providing practical recommendations for integrating TIC into standard care.