Reducing Re-Traumatization in Civil Commitment Court: Implementing Trauma-Informed Principles in Inpatient Psychiatric Settings

The destructive impact of trauma on one’s functioning is well documented and widespread, prompting many sectors to implement trauma informed care (TIC) guidelines to improve workplace health and safety outcomes. Inpatient psychiatric hospitals have received considerable attention in this regard. TIC approaches are crucial for inpatient settings since the experience of trauma increases violence risk and interferes with formation of a therapeutic alliance, thwarting treatment efforts. One area of inpatient psychiatric treatment that has remained untouched by TIC guideline implementation is civil commitment court (CCC). This is surprising since the focus of CCC relies upon testimony about the worst days of a patient’s life which is inherently traumatizing. To explore this gap, a brief survey assessing awareness of TIC guidelines and current and future implementation to CCC was conducted with staff (n = 44) at an inpatient state psychiatric hospital. Most participants (59.1%) reported familiarity with TIC principles, though familiarity varied markedly by role. Across all TIC principles, participants rated potential future implementation significantly higher than current implementation, yielding small-to-medium effect sizes, and indicating substantial potential for improvement. Clinical staff showed significant perceived gaps across all principles, while non-clinical staff showed significant gaps for most principles except Safety and Peer Support. Most participants (72.7%) were also in favor of TIC implementation into CCC. Findings highlight a critical opportunity to expand TIC into CCC to mitigate retraumatization, strengthen therapeutic engagement, and improve procedural experiences for individuals with serious mental illness. Policy and practice recommendations for trauma-informed adaptation of CCC are discussed.