Abstract

AbstractThis paper uses the principles of trauma-informed care – safety, collaboration, choice, trustworthiness, and respect – to reflect on the quality of veterans’ treatment within the UK social security system. Drawing upon new data from qualitative longitudinal research with veterans in four geographical locations across England, UK, it explores their experiences within the social security system, highlighting specific issues relating to their interactions with the Work Capability Assessment (WCA) but also the conditionality inherent within the UK benefits system. Overall, it is evident that there is a lack of understanding of the impact of trauma on people’s psychosocial functioning and, as a result, veterans are treated in ways which are variously perceived as disrespectful, unfair or disempowering and in some cases exacerbate existing mental health problems. We propose that the application of trauma-informed care principles to the UK social security system could improve interactions within this system and avoid re-traumatising those experiencing on-going or unresolved trauma. The paradigm of trauma-informed care has been used internationally to examine health, homelessness, prison and childcare services, but ours is the first exploration of its application to the delivery of social security.

Highlights

  • Originating in the US and subsequently moving to Australia, New Zealand and Canada, among other countries, a growing trauma-informed care movement is seeking to apply what is known about trauma to inform the design of human services (Quadara and Hunter, )

  • The issues that veterans with mental ill health experienced in accessing social security in the UK are similar to those described in the US literature on trauma-informed healthcare for veterans (Kelly et al, ; Currier et al, ; Gerber, ), and on trauma-informed human services more broadly (Harris and Fallot, ; Bloom and Farragher, a, b)

  • Our analysis suggests that there is much to be gained from the application of trauma-informed approaches to the social security system

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Summary

Introduction

Originating in the US and subsequently moving to Australia, New Zealand and Canada, among other countries, a growing trauma-informed care movement is seeking to apply what is known about trauma to inform the design of human services (Quadara and Hunter, ) This movement draws on neuro-scientific insights into the long-lasting effects of overwhelming, life-threatening experiences on the structure and functioning of the human brain, as well as insights from. Various human services whose central purpose is not the treatment of trauma are increasingly realising that many of their clients have (sometimes undisclosed) trauma histories These services recognise that how they treat their clients impacts on whether they can heal and recover from trauma, and enables services to anticipate and overcome the barriers which can prevent clients from engaging fully (Bloom and Farragher, a). Mental health, drug and alcohol, homelessness, domestic violence and children’s services, as well as schools and custodial institutions, among others, are proactively redesigning their operations to avoid inadvertently re-traumatizing service users (see for example, Ko et al, ; Hopper et al, ; Kelly et al, ; Muskett, ; Levenson, )

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