With less than a week to go until Mental Health Today Live, where we will be putting a spotlight on trauma-informed and workplaces, in this article, we introduce trauma-informed practice and how it can relate to all our workplaces.

The Covid-19 pandemic has touched all our lives – illness, bereavement, isolation, job and personal insecurity – have all been a significant source of stress and pain. But for people already living with prior experiences of trauma, these psychosocial stressors have increased the risk of further psychological harm. And unfortunately, the virus and its effects have been most keenly felt by those with prior experiences of trauma, disproportionally hitting the poorest, the most vulnerable, and socially disadvantaged.

The catastrophic impact of the pandemic, and its strain on a society already entrenched with long-standing social inequalities, have left individuals reeling and shellshocked. In this situation, it is unsurprising that the first aid charity, St John Ambulance, found that eight in ten workers feel that their mental health is worse or more varied as a result of the last year, 90% are concerned about a colleagues mental health, and 44% have considered leaving their job for their mental wellbeing.

Similar studies, like the one conducted by 87%, came to the same conclusion finding high levels of anxiety, fatigue, and isolation, which have only been rising in recent years across the UK workforce. If left unmanaged and unrecognised in systems, these feelings can ultimately lead to poor outcomes at work, toxic environments, staff absences, and inevitably to widespread burnout.

The impact of mental ill-health on workplace environments

The Mental Health Foundation estimates that in the UK, 70 million workdays are lost each year due to mental health issues costing employers per year around £2.4 billion. Sectors with high absences are naturally concentrated in professions with high levels of stress and risk of trauma. For example, workplace wellbeing organisation FirstCare found that from June 2020 to June 2021, mental health absences in the NHS were higher than Covid-19 related absences, with 2.5 million working days lost compared to 2.1 million. Additionally, their figures indicated that the duration of the mental health absences was, on average, treble that of Covid-19 absences.

Globally the WHO estimates that mental ill-health costs $1 trillion each year in lost productivity. Although the WHO report this doesn’t need to be the case, workplaces that strategise, promote, and standardise good mental health are more likely to reduce absenteeism, increase productivity, and benefit from associated economic gains. This win-win formula, the WHO says, means creating the mental health informed infrastructure necessary to mitigate work-related risk factors for negative wellbeing, the promotion of resilience and the positive aspects of working, and the addressing of mental health problems regardless of the cause.

Some of the workplace risks to mental health identified by the WHO include:

  • Inadequate health and safety policies.
  • Poor communication and management practices.
  • Limited participation in decision making.
  • Low levels of support for employees.
  • Inflexible hours.
  • Bulling or psychological harassment.

Understanding the influence of childhood trauma in workplaces

The ground-breaking 1998 Adverse Childhood Experiences (ACEs) study demonstrated the connection between multiple childhood risk factors linked to trauma and adverse outcomes in adulthood such as mental health problems, substance misuse issues, and worse physical health. Because of high levels of stress and unresolved trauma, people with high ACE scores (four or more out of the initial 1998 study’s seven factors) are more vulnerable to being re-traumatised and are statistically less resilient to stressors and adversity. Furthermore, these various traumatic childhood experiences are widespread. Research shows that more than 60% of adults report an ACE score of at least one, and almost 25% report three or more, implying a widespread need to mitigate these experiences in childhood as well as understand their lasting effects in adult behaviour and physical and emotional problems.

The implications of the 1998 study for workplaces are, as mentioned above that adversity experienced during childhood manifests itself across adulthood and into the various environments that people interact with. Evidenced by the ‘Childhood Abuse Household Dysfunction, and Indicators of Impaired Adult Worker Performancestudy, which found that experiencing ACE related childhood stress indicators impairs worker performance and is strongly associated with increased likelihood of job problems, financial problems, and absenteeism.

Researchers in the study concluded: ‘If even a small fraction of the economic and human resources currently spent on these conventional approaches were used to identify and address the root origins of these problems in the workforce, we could reasonably expect to find more effective ways to improve worker health, wellbeing, and performance.’

The implication of the ‘Worker Performance’ study is not for employers to evaluate employees' ACE scores. Instead, the conclusion signifies the need for management to understand the connection between workplace behaviour, performance, and individual mental health, and then in both parties' interest to signpost to support and enhance the protective standards of wellbeing in their organisational culture and practice.

What is a trauma-informed approach to workplaces?

A trauma-informed approach to workplaces shifts the focus from "what's wrong with you?" to "what happened to you?" acknowledging the whole holistic picture of a person's life – past and present – in order to produce better workplace outcomes.

Succinctly, the Substance Abuse and Mental Health Services Administration, a branch of the US Government, uses a four Rs rule to describe a trauma-informed organisational programme:

  • Realise the impact of trauma and understand the pathways to recovery.
  • Recognise the signs and symptoms of trauma in staff.
  • Respond by integrating knowledge of trauma into policies, procedures, and practice.
  • Activity resist re-traumatisation.

This year, an example of this approach to workplaces was published by the International Standards Organisation, which released the first international guidance on workplace mental health. The ISO 45003 framework addressed the areas that can adversely impact a worker’s mental health, including those highlighted by the WHO, such as poor communication, management policies, and organisational culture. The document suggests that management and HR departments need to proactively implement policies that understand employees' psychological needs and produce an internal culture that responds to those needs.

There are many ways to implement a trauma-informed approach to workplaces. However, the overarching aim of those approaches is to create a workplace culture based on empathetic understanding, capable of responding to the needs of staff members and able to nurture their wellbeing.

Tackling mental health issues and their interface with employment means leadership gaining insight on mental health and trauma and then thinking in a macro-organisational and a micro-events level to how good practice and policy can be used to enrich the daily lives of employees.

Against the backdrop of what has been called ‘The Great Resignation’ – the worldwide record exodus of employees, due in part to the pandemic – a restoration of the workplace status quo isn't enough when the 'old normal' wasn't working for everyone. Workplaces have, in many cases, been part of the problem for many employees mental ill-health, as they have not been responsive to their past and normal psychological needs, or have acted inherently 'inhuman' in how they have not attempted to understand the needs of their employees' psychological wellbeing. Therefore, in the ‘new normal’ policies, practices, and the culture of organisations will need to be responsive both to the lingering trauma and anxieties of the ongoing pandemic while also learning lessons from it.

Covid-19 has been a great equaliser, everyone has shared in a moment of profound cultural trauma and have in some way had their mental health touched by the fallout. Likewise, during lockdowns many have had time to reflect on their daily standards of living, and on their working conditions as approaches to working fundamentally transformed. Consequentially, many have considered their work-life balance and have concluded that stresses of work are not necessarily an inevitability but are inbuilt into a system that doesn’t put their emotional wellbeing at heart.



On November 10th at 6pm, Mental Health Today will be hosting – ‘How Can Trauma Inform Our Workplaces and Schools?’ – a MHTLive webinar. Register now and develop your knowledge of Adverse Childhood Experiences and trauma, and learn how schools and workplaces can be transformed into centres of recovery and healing.'