Do mental health clinicians elicit a history of previous trauma in female psychiatric inpatients?

BACKGROUND: A history of trauma is linked to the development of a wide range of mental health problems, and has long-lasting physiological and psychological consequences. The importance of clinicians directly questioning trauma history has been consistently emphasised in the literature.

AIMS: To investigate whether a trauma history is obtained from female psychiatry inpatients during an inpatient admission.

METHODS: The study was a retrospective file audit of 100 female patients admitted to the psychiatric ward of a major metropolitan Melbourne Hospital between December 2013 and November 2014.

RESULTS: In the files of 51% of patients there was no mention of whether or not the patient had a trauma-abuse history. Eight percent of patients had documentation stating there was no trauma-abuse history. Forty-one percent of the patients had documented evidence of a trauma-abuse history, although only 3% of these patients had a specific description provided. The presence of current illicit drug use and the diagnosis of borderline personality disorder were the only variables associated with an increase in the likelihood of having a documented trauma-abuse history.

CONCLUSION: There is a need for clinician retraining, a trauma-informed care model and the incorporation of mandatory inquiry in best practice guidelines to generate a shift in culture in the delivery of mental health care services.