Teresa Lines works as a humanitarian management professional supporting the FCDO. She has experience managing professional teams and providing a safe and secure environment for refugees. Terri Lines is currently engaged as a Trauma Risk Incident Manager for an FCDO Security Humanitarian team. This article will look at trauma risk management, identifying strategies for employers to support their staff following a potentially traumatic event.
Trauma Risk Incident Management (TRiM) is a method used to prevent and mitigate Post Traumatic Stress Disorder (PTSD) and other stress-related mental health disorders. The TRiM process involves non-healthcare staff monitoring and managing colleagues. TRiM training helps TRiM managers and practitioners to understand psychological trauma and its wide-ranging effects.
As a trauma-focused peer support system, TRiM is wholly compliant with PTSD management guidelines produced by the US National Institute for Health and Care and Excellence. TRiM practitioners are trained to carry out interviews with candidates, identifying risk factors that increase the likelihood of a person suffering poor mental health in the long-term following a traumatic event.
Today, TRiM is applied by numerous public and commercial organisations, including emergency services, charities, risk management organisations and security firms. TRiM is also used by UK Government bodies, including the Foreign and Commonwealth office, transportation organisations, media companies including the BBC, the oil and gas industry and the police.
TRiM is a welfare led process developed to assess responses of members of staff to potentially traumatic incidents. Recognising the foreseeable risk of individuals exposed to traumatic incidents developing long-term mental health problems, many employers rely on TRiM today, training TRiM managers and practitioners to protect the welfare of workers. Complying with the UK’s National Institute for Health and Care Excellence (NICE), TRiM is used to manage PTSD in adults as well as children in primary and secondary care.
The objectives of TRiM are to provide trained TRiM practitioners, enabling them to manage staff following a potentially traumatic incident. TRiM practitioners identify aspects of an incident that may require intervention, ensuring that supervisors and managers have adequate guidance for the ongoing support and management of staff. TRiM enables supervisors to identify members of staff who may require intervention at an early stage, as well as providing training to personnel involved in the planning and implementation of TRiM strategies. TRiM also highlights the importance of activating procedures within an appropriate time frame, providing information to staff and management to enable them to recognise normal reactions to traumatic situations.
TRiM conversations are entirely confidential between the TRiM practitioner and the member of staff. Information divulged in these interactions should only be shared where a plan for signposting or information sharing has been created. TRiM practitioners have a duty to escalate in situations where there are safeguarding concerns.
Initial TRiM interviews should be conducted within 72 hours of the occurrence of a traumatic incident. Individuals who score highly in the initial interview should be provided with extra support by line managers and colleagues where appropriate. A follow-up interview should then be staged approximately one month later to assess how well the person has come to terms with the traumatic event by that point. Individuals who demonstrate persistent difficulties should be encouraged to undergo a professional assessment to assess any specific treatment required.
TRiM was developed by the British military after scientific scrutiny revealed that previously used models of post incident intervention not only lacked effectiveness but actually posed potential to do harm. Professor Neil Greenberg, an academic psychiatrist based at London’s King’s College, formed part of the team at the forefront of developing TRiM, drawing on his experiences and expertise as a consultant forensic and occupational psychiatrist.