We can’t give what we don’t have: Using trauma and resiliency informed practice to enhance provider wellbeing and improve patient experiences

Background: Emergency departments (EDs) are experiencing increasing presentations related to mental health and substance use (MHSU) disorders. Structural issues in the ED, including overcrowding, limited support, high workloads, and delays in care contribute to stigma experienced by MHSU patients and provider burnout, secondary traumatic stress, and psychological distress. These issues highlight the need for organizational and educational supports for ED staff, particularly focused on trauma, emotional regulation, and stigma reduction. To address this need, a research informed Trauma and Resiliency Informed Practice (TRIP) workshop was piloted with ED staff. Study Objectives: This nursing-led study aimed to address the following questions: 1) Do healthcare providers feel that TRIP improved their ability to provide trauma informed care for people with MHSU issues? 2) Did participation in TRIP reduce stigmatizing attitudes and behaviours toward people with MHSU? 3) Did participation in TRIP improve providers’ self compassion and resiliency skills? 4) Do the benefits of TRIP persist over time? Methods/Implementation: Researchers implemented TRIP training with 64 ED staff at a major hospital in Canada. A pre-post-follow-up design was used. Eleven 4-hr workshops and one 2-hr workshop were delivered, measuring stigma towards patients with MHSU concerns, provider self-compassion and resilience using both quantitative and qualitative measures. Evaluation/Results: Significant improvements were seen in all scores for the 4-hr workshops, with the strongest improvements in provider resiliency for the 2-hr workshop, with results sustained at 6-month follow-up. Qualitative feedback for both 4-hr and 2-hr workshops demonstrated a strong intention to apply TRIP principles, engage in self-compassion practice, and use emotional regulation techniques. Implications/Lessons Learned: As both qualitative and quantitative findings reinforced the connection between provider wellbeing and patient care, addressing the emotional and moral distress needs of providers may be an important consideration for reducing stigma. Leaders are encouraged to explore how such a trauma and resiliency-based model may be implementable for their own organizations. Suggested future directions for TRIP include formally rolling out trauma informed care as an organization wide structural intervention, addressing barriers to staff participation, and inclusion of follow up or refresher sessions. Presentation Objectives: This presentation aims to deepen participants’ understanding of the drivers of mental health–related stigma in ED settings and to equip them with concrete tools to reduce stigma while enhancing their own wellbeing. The session has three objectives: (1) to explore how stigma operates at structural, interpersonal, and intrapersonal levels, how it manifests in the ED environment, and how provider wellbeing directly influences patient experiences; (2) to introduce and practice emotional regulation strategies that can be applied in both personal and professional contexts; and (3) to develop participants’ knowledge and skills in TRIP, an evidence-based, multi-component intervention shown to reduce stigma, improve provider wellbeing, and strengthen compassionate, patient-centred care.