Lessons Learned Implementing a Trauma-informed System of Care in Rural Communities

Background: The negative impact of trauma on health is devastating. Providers, especially those in rural areas, require support to implement trauma-informed care (TIC) on a systems level.Objectives: This paper describes a partnership of county behavioral health administrators, service providers, and a behavioral health managed care organization and steps taken over a 5-year initiative to enhance capacity and quality of community services to meet the needs of individuals in a rural setting to receive TIC. Methods: The initiative included trainings in evidence-based and best practices in TIC, improved trauma screening, development of TIC centers, and development of community-based networks for ongoing support. Lessons learned were summarized through discussions between partnership members.Lessons Learned: Shared ownership, opportunity to build networks, and continuous assessment of organizational strengths resulted in successful implementation and sus- tained practice. Challenges included turnover among staff and organizations.Conclusions: Building a TIC network across a rural health care system can be successful with long-term support and investment from multiple stakeholders.