Nursing interventions for adults following a mental health crisis: A systematic review guided by trauma-informed principles

Abstract

There exists a growing need for health and service providers to respond to persons in a manner that recognizes the prevalence and impact of trauma in individuals and prevent inadvertent re-traumatization in the routine process of care. The experience of mental health crisis in of itself can have traumatic and impactful effects on individuals. Trauma-informed approaches to care offer a framework to provide crisis intervention responses that are based on the acknowledgement of the prevalence and impact of trauma and define trauma not by the event per se, but by the impact of an experience of trauma. The integration of trauma-informed principles in the context of crisis intervention is a current practice gap. In order to inform a portion of a best-practice guideline for registered nurses and the interprofessional team, a systematic literature review was conducted to primarily identify nursing interventions within four weeks of a mental health crisis, with a secondary focus on identifying particular interventions that included trauma-informed principles. The systematic review yielded 21 quantitative and qualitative studies related to nursing interventions for mental health crisis, 10 of which referred to one or more principles of trauma-informed approaches. There was a lack of studies on nursing interventions explicitly linked to implementation of trauma-informed principles, highlighting future research needs and focused efforts to integrate trauma-informed principles into crisis intervention practices.

Keywords: best-practice guideline; mental health crisis; mental health nursing; trauma-informed.