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On the frontline with Trauma Risk Management

TRiM (Trauma Risk Management) has been shown to improve mental health and attitudes towards mental health in high-risk occupational groups such as front line emergency workers, NHS staff and military personnel.

A secondary form of PTSD (and other traumatic stress related mental health disorders) prevention. The TRiM process enables staff to monitor and manage colleagues. TRiM training provides individuals with a background understanding of psychological trauma and its effects.

TRiM is a trauma-focused peer support system and the way it works is wholley compliant with the PTSD management guidelines produced by the National Institute for Health, Care and Excellence. Trauma risk management Practitioners are trained to carry out an interview which identifies a number of risk factors which, when present, increase the likelihood that an individual may suffer poor long term mental health as a result of a traumatic event. The initial TRiM interview takes place with an individual, 72 hours after a traumatic incident. People who score highly on this initial interview are provided with extra support by immediate- trained colleagues, and where appropriate, line managers. A follow up TRiM interview is then carried out approximately one month later to assess how well people have come to terms with the traumatic event at that point. Individuals who are found to have persistent difficulties at this point are encouraged and assisted to seek a professional assessment of their mental health in order to access the specific treatment they require to support them fully.

TRiM originated after the previously-used reactive single session models of post incident intervention, such as Critical Incident Stress Debriefing, were subject to scientific scrutiny and shown to not just lack effectiveness but also have the potential to do harm.

Although it was first used in the UK military, trauma risk management is now used by a range of public and commercial organisations. This includes charities, emergency services, security firms, risk management organisations, UK Government departments including the Foreign and Commonwealth Office, the oil and gas industry, transport organisations and media companies.

Professor Neil Greenberg was one of the team at the forefront of developing peer-led traumatic stress support packages, now known as TRiM. He is an academic psychiatrist based at King's College London UK and is a consultant occupational and forensic psychiatrist.

Does my organisation need TRiM

  • If your organisation operates in a high risk, or high threat location, or in the course of day-to-day work staff are likely to face traumatic or potentially traumatic situations, then you should consider TRiM

  • The implementation of TRiM has benefited many 'at risk' organisations – legally (by providing a duty of care); economically (by keeping people at work) and morally (by looking after personnel)

How does TRiM benefit my organisation

  • Saves money - good mental health practices in an organisation can help to reduce sickness absence and presenteeism

  • Shows a legal duty of care to employees

  • Helps to break the stigma of mental health – this not only supports your work force but can lead to early interventions thus reducing sickness or absence as above

  • Building a resilient workforce through TRiM outside the time of a crisis can help during a difficult time or when crisis hits

SEPAR International deliver a number of Medical Trauma courses and private one 2 one assessments and consultations covering elements of TRiM, Medical trauma, Mental Health and crisis medical.

Our in-house PTSD specialist Nick Stephens qualified as a mental health nurse more than 35 years ago, cutting his teeth in a large Victorian psychiatric hospital with some 1500 staff and around 2000 patients. His specialism was secure services, or ‘forensic psychiatry’ as it later became known and was seconded to Rampton special hospital and, after qualifying as a nurse, moved into the private sector in medium security. He became interested in behavioural theory and trained as a cognitive therapist - and later as a PTSD counselor - both of which gave him an opportunity to help people address, not only their mental health issues, but learn how their behavior at once influenced, and was a result of, their experiences and feelings. Which steered his career into Forensic Rehabilitation.

He currently runs a Mental Health Recovery facility and occasionally guest-lectures at University of South Wales as well as working closely with SEPAR International on Mental Health consultancy.


Kings College London - Peer support to overcome trauma

NHS England - Supporting Staff through Trauma Risk Management

Greenberg N et al. Trauma risk management (TRiM) in the UK Armed Forces. JR Army Med Corps, 2008; 154 (2): 124-7

Pinder RJ et al, Mental health care provision in the UK armed forces. Mil Med, 2010 Oct; 175(10): 805-10

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