innovations in health care
Trauma-Informed Care: A New Perspective in Providing Human Services Sheilah H. Dooley, RN, BSN, MS
Recognizing the prevalence of trauma in the lives of those it serves, Pernet Family Health Service, Inc. is joining the growing number of human services providers nationwide taking steps to employ TraumaInformed-Care practices into its service delivery. Pernet Family Health Service is a nonprofit human service agency located in Worcester’s Green Island neighborhood. Founded in 1968 by an order of religious sisters, The Little Sisters of the Assumption, whose mission was to provide health care and support to the disadvantaged families and to revitalize the spirit of those degraded by poverty, Pernet has remained steadfast in that mission, all the while seeking to advance its practices and embrace innovation, and to be responsive and impactful in the delivery of care. The Sisters chose the intersection of Kelley Square, Green Island, and Vernon Hill for its site because sixty years ago, it was home to the greatest poverty in Worcester. This particular census tract is still predominantly populated by families living at or below the poverty line. Resources are scant. There are no grocery stores or healthcare facilities. The only human service agency is Pernet. Pernet provides a wide variety of services addressing the needs of all ages, from at-risk expectant mothers and newborns, to early childhood, school-aged and the elderly. Home-based Clinical Services include Maternal and Infant Health Nursing; Early Intervention; Parent Education and Support; and Homemaker Services. Site-based Community Services include an Emergency Pantry of food, infant formula and diapers; Youth Services – homework assistance, recreation, and a jobs program for neighborhood children, youth jobs; Information and Referral to other community resources; Holiday Assistance; Family Outings; and Summer Activities. Pernet is a robust resource in a neighborhood that has precious few resources. The people served by Pernet represent a population that is largely invisible. They are poor or struggling. Many lack a formal education. Some have criminal histories, struggle with addiction and mental health issues, are victims of abuse, experience language barriers and have immigration issues. Most have experienced some sort of trauma. And they are not alone. The CDC reports that one in four children experiences some sort of maltreatment (physical, sexual, or emotional abuse). One 12 | Worcester Medicine January/February 2020
in four women has experienced domestic violence. In addition, one in five women and one in 71 men have experienced rape at some point in their lives — 12% of these women and 30% of these men were younger than 10 years old when they were raped. Thanks to a three-year grant from the Sills Family Foundation, Pernet will be creating an agency-wide training and reinforcement program, to introduce and implement the practice of Trauma-Informed Care. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines a trauma-informed approach to services as one that includes the following principles: Safety – physical and psychological Trustworthiness & Transparency – fostered over time by building and maintaining trust between staff and clients Collaboration & Mutuality – partnering and relationship building between clients and all members of the agency that respects and shares power and mutual decision making Peer Support & Mutual Self-Help – defined by SAMHSA as “valuing lived expertise; it should be available and nurtured by the provider or agency” Cultural, Historical & Gender Issues – a respect for differences, intentional avoidance of bias or stereotyping, appreciation of the value of cultural norms and traditions, and attention to traumatic histories
