Overview

Trauma and violence are widespread, harmful, and costly public health concerns. They have no boundaries with regard to age, gender, socioeconomic status, race, ethnicity, or sexual orientation. Trauma is a common experience for adults and children in American communities, and it is especially common in the lives of people with mental and substance use disorders. For this reason, the need to address trauma is increasingly seen as an important part of effective behavioral health care and an integral part of the healing and recovery process.

Working Definition of Trauma and Scope of the Issue

SAMHSA describes individual trauma as resulting from "an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual's functioning and mental, physical, social, emotional, or spiritual well-being."

Consider:

• A lifetime history of sexual abuse among women in childhood or adulthood ranges from 15% to 25%. The prevalence of domestic violence among women in the United States ranges from 9% to 44%, depending on definitions.
• The cost of intimate partner violence, which disproportionately affects women and girls, was estimated to be $8.3 billion in 2003. This total includes the costs of medical care, mental health services, and lost productivity.
• In a 2008 study by RAND, 18.5% of returning veterans reported symptoms consistent with post-traumatic stress disorder (PTSD) or depression.
• In the United States, 18.9% of men and 15.2% of women reported a lifetime experience of a natural disaster.

The effects of traumatic events place a heavy burden on individuals, families, and communities. Although many people who experience a traumatic event will go on with their lives without lasting negative effects, others will have difficulties and experience traumatic stress reactions. How someone responds to a traumatic experience is personal. If there is a strong support system in place, little or no prior traumatic experiences, and if the individual has many resilient qualities, it may not affect his or her mental health.

Research has shown that traumatic experiences are associated with both behavioral health and chronic physical health conditions, especially those traumatic events that occur during childhood. Substance use (such as smoking, excessive alcohol use, and taking drugs), mental health conditions (such as depression, anxiety, or PTSD), and other risky behaviors (such as self-injury and risky sexual encounters) have been linked with traumatic experiences. Because these behavioral health concerns can present challenges in relationships, careers, and other aspects of life, it is important to understand the nature and impact of trauma, and to explore healing.

In addition, traumatic experiences can contribute to chronic physical health conditions, such as diabetes and cardiovascular diseases.

SAMHSA Leads Federal Efforts to Address Trauma

SAMHSA is addressing the impact of trauma on individuals, families, and communities by promoting the development of trauma interventions and trauma-informed approaches through grant funding, funding of technical assistance centers, original publications and webinars, collaborative partnerships with government and nongovernment entities, and special initiatives. The contributions include:

• Developing and promoting trauma-specific interventions
• Expanding trauma-informed care services and training among the workforce and capacity of organizations
• Publishing a conceptual framework for trauma and implementing trauma-informed approaches to guide SAMHSA's work and to support the efforts of other agencies, systems, and organizations
• Recognizing trauma and its behavioral health effects across health and social service delivery systems

Learn more about:

• Types of Trauma and Violence
• Grants Related to Trauma and Violence
• Publications and Resources for Trauma and Violence
• Alternatives to Seclusion and Restraint