How is trauma-informed care conceptualised in UK mental health services? Systematic scoping review protocol.

Abstract

Introduction: Trauma-informed care (TIC) has attracted considerable attention globally as a framework for addressing the profound impacts of trauma on individuals and communities. Despite its widespread adoption, the definition and operationalisation of TIC remain inconsistent across contexts, including the United Kingdom. TIC represents a systemic shift in healthcare and social care practices, moving from a focus on immediate issues to addressing the underlying effects of violence, childhood adversity, and trauma. This approach is particularly pertinent in the UK, where there is growing interest in TIC across the health, social care, and criminal justice sectors.This systematic scoping review aims to shed light on how TIC is defined and applied in the UK. By synthesising existing literature, it seeks to clarify the conceptualisation of TIC, identify gaps in implementation, and contribute to ongoing efforts to standardise trauma-informed approaches. The review is motivated by the UK's proactive yet fragmented adoption of TIC, as evidenced by recent initiatives and sector-specific adaptations. By examining these developments, the review aims to inform policy and practice, ultimately enhancing the delivery of trauma-informed care in the UK.

Methods: We systematically searched for primary studies in PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Medline to explore how TIC is defined in the UK. Grey documents that described TIC principles, evaluation, and implementation within mental health care services in the UK were selected. Data from selected studies and grey documents, including handbooks, policies, or training materials, were systematically extracted, focusing on the document characteristics, TIC principles, implementation strategies and evaluation methods. Studies were then selected in English from the last 15 years of work, focusing on TIC practices within the mental health care system in the UK. Data were then analysed to describe TIC principles within mental health care services, identify important concepts of TIC and explore implementation and evaluation methods. This would enable us to understand the broader components of how TIC is defined.

Ethics and dissemination: This systematic scoping review did not require ethical approval. The findings will be disseminated through peer-reviewed publications in academic journals specialising in mental health, trauma, and healthcare management, conference presentations, online platforms such as the research team's website, social media channels, community organisations, advocacy groups, or patients.