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Royal Commission into Victoria’s Mental Health System

Case study:

Latrobe Regional Hospital

Latrobe Regional Hospital

Latrobe Regional Hospital (LRH) is the main provider of mental health services across Gippsland, offering a broad range of services including inpatient, community residential, and prevention and recovery care. LRH cares for a community of more than 260,000 people, many of whom have experienced a traumatic event or series of events, for example, bushfires and the Hazelwood mine fire, which has led to or exacerbated poor mental health.

Staff at LRH observed high numbers of young people whose mental health had been affected by traumatic or adverse events in their early development. Based on this, along with significant research indicating the impact of trauma neurobiologically and the need for ongoing management, it was determined that trauma‑informed practice should be integral to the mental health services they provide in their community.

Ms Cayte Hoppner, Executive Director of Mental Health and the Chief Mental Health Nurse, said LRH has implemented a model of trauma‑informed care driven by a new model of education for staff focused on ‘a change in language and how we work differently with people’.

We started asking ‘what has happened to you?’ rather than ‘what is wrong with you?’ and asked how we can support them through the service system. The training recognises that it could be retraumatising coming into the system to seek help.

All staff are involved in the training, including nurses, reception and other hospital staff (for example, cleaning staff), in recognition that a person can be retraumatised by their first point of contact with a service, if that contact does not consider the trauma history of the person. LRH has also adopted processes that enable staff to reflect on their approach to trauma‑informed practice, to encourage them to stay committed to it. Further, to ensure that trauma is considered in all contexts, the training is embedded into more specialised staff training modules run by LRH.

Ms Hoppner explained that LRH’s lived experience workforce was critical to developing the training and was involved at every step.

Lived experience groups have strong links with our education and training unit, plus our training development and service delivery. The voices of those with lived experience are valued in our ongoing structure.

Ms Hoppner said LRH did face challenges in implementing the trauma‑informed approach, as there are large geographic distances between the services it provides.

We have a large number of sites so ensuring that the learning and understanding was consistent was hard. We also worked to develop a trauma‑readiness guide that any service could use in the region. We wanted the practice and approach around language to be the same across all services.

Initially, it was also challenging to convince everyone of the need for practice change.

A key challenge was some staff groups thought it wasn’t relevant to them, but when they attended the training they found it particularly rewarding.

An initial evaluation has noted the success of the training, but Ms Hoppner said the hospital is now reviewing the experiences of five consumers per month to assess progress and benefits.

We know our training is right, but sustaining the practice change is the hard part. It’s what we need to concentrate on now to translate better outcomes for patients. Reviewing records and talking with consumers will provide us the qualitative feedback to help us improve.

Ms Hoppner noted that further success can be achieved by extending the trauma‑informed approach ‘beyond the education framework into the policy and procedure environment’, such as human resource practices and organisational governance, and by ensuring management across the organisation is engaged in the approach.

LRH is now working to extend the reach of the training to other services across LRH and to embed it further within its training program.

Source: RCVMHS meeting with Latrobe Regional Hospital, 11 June 2020; Latrobe Regional Hospital, About us, [accessed 29 June 2020].

Photo credit: Latrobe Regional Hospital