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. 2025 Aug;49(4):265-268.
doi: 10.1192/bjb.2024.103.

Whose trauma is it anyway? Creating more equitable mental healthcare in a system that harms

James Downs  1
Affiliations

Whose trauma is it anyway? Creating more equitable mental healthcare in a system that harms

James Downs. BJPsych Bull. 2025 Aug.

Abstract

Past experiences of mental healthcare which have been perceived as harmful can present significant barriers to accessing treatment again. This article draws upon research and lived experience to consider the ways in which conceptualisations of 'trauma-informed care' may better incorporate the role of iatrogenic harm, thus providing more acceptable and equitable treatment for those who have previously found treatment to be harmful. A more restorative approach is offered, founded in shared responsibility and compassionate relationships, to help minimise harms and create a more healing system for patients and clinicians alike.

Keywords: Trauma; complex trauma; iatrogenic harm; inclusion; lived experience.

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Conflict of interest statement

None.

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