Do mental health clinicians elicit a history of previous trauma in female psychiatric inpatients?

J Ment Health. 2016 Aug;25(4):359-365. doi: 10.3109/09638237.2016.1139074. Epub 2016 Feb 5.

Abstract

Background: A history of trauma is linked to the development of a wide range of mental health problems, and has long-lasting physiological and psychological consequences. The importance of clinicians directly questioning trauma history has been consistently emphasised in the literature.

Aims: To investigate whether a trauma history is obtained from female psychiatry inpatients during an inpatient admission.

Methods: The study was a retrospective file audit of 100 female patients admitted to the psychiatric ward of a major metropolitan Melbourne Hospital between December 2013 and November 2014.

Results: In the files of 51% of patients there was no mention of whether or not the patient had a trauma-abuse history. Eight percent of patients had documentation stating there was no trauma-abuse history. Forty-one percent of the patients had documented evidence of a trauma-abuse history, although only 3% of these patients had a specific description provided. The presence of current illicit drug use and the diagnosis of borderline personality disorder were the only variables associated with an increase in the likelihood of having a documented trauma-abuse history.

Conclusion: There is a need for clinician retraining, a trauma-informed care model and the incorporation of mandatory inquiry in best practice guidelines to generate a shift in culture in the delivery of mental health care services.

Keywords: Mental illness; psychiatric inpatients; psychiatry wards; trauma history.

MeSH terms

  • Adult
  • Battered Women / psychology*
  • Female
  • Humans
  • Inpatients / psychology
  • Mental Disorders / diagnosis*
  • Mental Disorders / psychology
  • Mental Health Services*
  • Mentally Ill Persons / psychology*
  • Patient Admission
  • Physical Abuse / statistics & numerical data*
  • Psychiatric Department, Hospital
  • Retrospective Studies