Trauma-informed care: asking “what happened to you” instead of “what is wrong with you?”

With the conversation on mental health more prominent today than ever before, we can see that anybody can be affected by mental illness or trauma. Some people, especially youth who are street-entrenched and facing homelessness, are particularly vulnerable, and a large portion of these youth have lived through numerous traumatic events in their lifetime.

It’s a grim reality that most Canadian youth experiencing mental health issues are unable to access the care that they need. According to the Mental Health Commission of Canada, a staggering 1.2 million children and youth in Canada are affected by mental illness every year, but less than 20 percent are receiving proper care.

Among the many complex factors that hold youth back from seeking help is the fear of being judged by healthcare providers. These anxieties are only amplified in cases where an at-risk youth has a history of violence or drug use.

Through compassionate, trauma-informed care, a better future is possible for all youth who are struggling by fostering systems that place the person at the centre of care.

What is trauma-informed practice?

In short, trauma-informed practice is when caregivers seek to understand patients and their experiences—as normal reactions to abnormal situations.

Every person deserves dignified and respectful treatment that recognizes their survival skills, which have been adapted to face traumatic situations. Care providers who are committed to trauma-informed practice recognize that anyone could be affected by traumatic experiences and respond with compassion and understanding.

Trauma-informed practice is founded in understanding the various ways in which trauma can affect how a person asks for and receives help. This approach forges a long-lasting patient-caregiver relationship built on trust, rapport, collaboration, and resiliency.

For example, trauma-informed care providers understand that substance use is a learned response to coping with a traumatic environment, and meet individuals with respect, dignity, and compassion. Without this approach, providers are unlikely to be able to provide appropriate help.

Kyrsten Boucher, the Clinical Program Manager for Directions Youth Haven, has seen firsthand how trauma-informed practice and harm reduction can change lives.

How Directions Youth Haven is changing the lives of Vancouver youth

Run by Family Services of Greater Vancouver, Directions Youth Haven is a five-bed, low-barrier safe house for homeless and at-risk youth between the ages of 16 and 19. According to Boucher, employees at Directions Youth Services are committed to creating a space where youth feel supported and are recognized as whole individuals.

At Directions, youth work towards individually-set goals and celebrate their accomplishment during every step of their recovery. For some, being able to stay in the resource centre for more than 24 hours, or simply eating a meal with others, is a sign of progress.

Boucher also says that it is important to recognize that youth who have survived traumatic experiences often develop resilient ways of coping and protecting themselves. Some of these coping mechanisms may include behaviours that are often misunderstood or present as barriers to accessing other services such as aggression or substance use, but at Directions, these behaviours will not necessarily lead to discharge.

Instead, staff provide youth with opportunities to recognize their own capacities, build alternative coping strategies, and practice setting appropriate boundaries to create safety.

Another priority at Directions is to help youth separate themselves from feelings of shame. “This can be as simple as helping a youth change from saying ‘I’m a bad person’ to ‘I would make different choices’,” said Boucher. Treating individuals with respect and empathy allows for them to start seeing themselves beyond their trauma and experiences.

For Boucher, the positive impact of trauma-informed care is clear. At Directions Youth Haven, at-risk youth can work toward their own goals and develop a strong rapport with staff, which wouldn’t be possible without compassionate, non-judgmental care.

“Being low-barrier means taking a person-first approach and meeting people where they are at,” Boucher says. “Being trauma-informed is about asking ‘what happened to you,’ not ‘what is wrong with you?’”

The trauma-informed and client-centred philosophy creates safety for youth to access a full spectrum of supports including primary care, mental health, and substance use resources.

About Directions Youth Services
Run by Family Services of Greater Vancouver, Directions Youth Services is a collection of services supporting youth who are at-risk, street-involved or experiencing homelessness. This includes a 24/7 drop-in centre, outreach teams, pre-employment programs, two safehouses, and a youth detox centre.

To support the work of Directions Youth Services and to help youth get a chance to start a new life, you can make a gift here. Thank you for making a tangible difference in the lives of Vancouver youth.