June 17, 2024.

In today’s health-care landscape, the importance of addressing not only physical but also emotional, mental, social and spiritual wellbeing has never been more crucial. Trauma-informed care, an approach that acknowledges the pervasive impact of trauma and integrates this understanding into clinical practice, is becoming a cornerstone of compassionate and effective health care. For the Frontenac, Lennox, and Addington Ontario Health Team (FLA OHT), delivering trauma-informed care for everyone in our region is a necessary and transformative step towards promoting equitable health and wellness and creating a more inclusive, empathetic and supportive health-care environment.

KFL&A Resilience Symposium
To further understand and integrate trauma-informed care into health-care delivery in the FLA region, members of the FLA OHT Access to Primary Care working group and Health Home support structure attended the KFL&A Resilience Symposium in October 2023. This symposium, organized by our partners at Kingston Community Health Centres (KCHC) and their Teach Resilience social enterprise, along with the Community Foundation for Kingston & Area and their Adverse Childhood Experiences & Resilience Coalition of KFL&A, provided invaluable insights on the impact of trauma on health outcomes. The event brought together community champions, decision makers, experts and practitioners to share knowledge on building resilience and implementing trauma-informed practices.

How to integrate trauma-informed care
Following the symposium, we started thinking of ways to action our commitment to trauma-informed care within the FLA OHT. “As providers, it’s on us to make everyone comfortable and safe in our spaces,” says Dr. Anna Chavlovski, Primary Care Physician and Chair of the FLA OHT Health Home Support Structure. “But the question is, how do we bring this kind of training—cultural safety, trauma-informed care, equity-oriented care—to providers who have not had that formal education as part of their training?” added Dr. Chavlovski. “I recognize this as a gap in my own knowledge and understand that I’m not an expert in trauma-informed care. That’s why I feel it’s crucial for the FLA OHT to facilitate connections between knowledge experts and practitioners - to help equip practitioners with the tools and understanding to recognize the impacts of childhood trauma and apply this knowledge to improve patient care.”

In an effort to bring this kind of training directly to the primary care providers in our community, we hosted a special documentary screening of Resilience: The Biology of Stress & The Science of Hope in April in partnership with KCHC and Teach Resilience. We invited the FLA primary care community to join us to increase their knowledge of trauma-informed care and how it can be applied within the FLA OHT and our People-Centred Health Homes.

Learning from a powerful documentary
Resilience explores the science of Adverse Childhood Experiences (ACEs) and the birth of a movement to treat and prevent Toxic Stress. It looks at how extremely stressful experiences in childhood can alter brain development, have lifelong effects on health and behaviour, and are one of the leading causes of everything from heart disease and cancer to substance abuse and depression.

The screening was followed by a panel discussion with community leaders and practitioners that delved into the ways trauma-informed care can be integrated into health-care practices here in our region. One of the key takeaways was the need for health-care providers to recognize the signs of trauma and create a safe, supportive environment for patients. “From a provider's point of view, we might sometimes get frustrated when patients may not follow our suggestions,” noted Dr. Chavlovski. “But often, it's because they are living with trauma and can’t move forward without the necessary supports. Recognizing trauma and its varied presentations is crucial for providing better care and improving patient outcomes.” 

Collaboration on trauma-informed primary care course
To further our commitment to trauma-informed care and provide more learning opportunities for providers in the FLA OHT, we hosted an accredited course on Trauma-Informed Approaches in Primary Care in May, in collaboration with Teach Resilience and the Ontario Medical Association. The course aimed to deepen understanding and application of trauma-informed practices among providers and emphasized its crucial role in our health-care system and its alignment with our Health Homes model.

As part of the course, Teach Resilience led a dynamic session on trauma-informed care and resilience building, highlighting the impact of ACEs on health outcomes. In the afternoon, KCHC and Queen’s physicians Mary Rowland and Rupa Patel, respectively, provided practical insights through case studies and discussions, helping attendees recognize triggers in practice environments, apply trauma-informed principles, and support emotionally dysregulated adults. Participants learned to identify trauma in primary care settings, explored effective strategies to support individuals with ACEs, and discussed the importance of integrating trauma-informed care into their daily work.

“Exposure to toxic stresses as a child can have a big impact not only on an individual’s mental health but also on their physical health throughout their lifetime,” shared Mary Rowland, Family Physician, Primary Health Care, Kingston Community Health Centres.

Building provider skills to help patients build resilience
“It may not come as a surprise that rates of depression, anxiety and substance use are higher amongst those with a history of Adverse Childhood Experiences (or ACEs), but providers may not always be aware that these individuals are also at higher risk of other types of diseases like diabetes, COPD and cancer. While the topic of trauma-informed care is starting to be taught in health sciences training programs, what is often missing is the practical application of this knowledge. Being able to recognize how past trauma may be impacting the presenting conditions we see often in a primary care practice can be a game-changer for providers. Having the skills to identify these presentations and feeling more equipped to support their patients in building resilience leads to better health outcomes for patients and improved provider wellbeing. Trauma-informed care delivered well can be truly transformative.”

By raising awareness and facilitating connections between knowledge experts and practitioners, the FLA OHT is playing a vital role in integrating trauma-informed care in Health Homes throughout the regions so that providers can ultimately better address the root causes of health issues and provide more effective integrated care. As we continue to explore the profound benefits and ongoing efforts to embed trauma-informed care within health care throughout the FLA OHT, we aim to illuminate the path towards a more understanding, resilient and healing health-care system for all.

"As we move forward, it's essential to think about how we can continue spreading trauma-informed care beyond primary care to all providers, including large institutions,” added Dr. Chavlovski. “By expanding this approach, we can ensure that every aspect of our health-care system is equipped to recognize and address trauma, ultimately leading to better care and outcomes for all.”