SAMHSA Removes One of the Principles of Trauma-Informed Care
TRAUMA-INFORMED CARE
You see it all the time in comments on social media: Don’t make this political. It’s a bullshit sentiment often made by people who don’t want to face accountability for the beliefs they hold that absolutely influence their vote, or by people who are privileged enough to believe they don’t have to care about what happens in politics. They want to live in a bubble where they just don’t have to think about the uncomfortable things. It’s a belief that’s part of our conditioning, especially here in the US. Don’t talk about politics or religion, right?
As I wrote in my first blog post here, everything is political. Whether you vote or not, the quality of the air you breathe, the food you eat, and the water you drink is determined by legislation and regulation. We live within borders determined by politics. What we learn in school is foundational knowledge that informs our perception of history, science, the arts and humanities, and beyond. Education is influenced by the political decisions we make. So is the healthcare you receive…or don’t receive. Or about not to receive, if you’re following the news about how the Medicaid cuts that will be rolling out after midterms will result in cutbacks and closures of hundreds of hospitals around the country. (For more on that, please check out this website.)
Mental health resources are affected as well. When this regime started their hate-fueled shenanigans after coming to power in early 2025, I followed the news about how scientists and science lovers alike were saving as much as they could from government websites before DOGE got their grubby ogre claws all over them. Inspired, I downloaded a bunch of information from the Substance Abuse and Mental Health Services Administration. And I’m glad I did, because they did indeed make some unwelcome changes that do affect people.
Ever since a medical crisis in 2021 led to several new diagnoses that changed my world, I’ve been talking about the importance of trauma-informed care. I’ve given talks about patient experience and trauma-informed care to healthcare professionals and medical students, and it’s the core topic of this platform I’m building. I’m currently working on a new presentation and just wanted to doublecheck the SAMHSA site to make sure I was citing things correctly.
So what did they change on SAMHSA’s site under RFK Jr.’s watch? They removed one of the principles of trauma-informed care.
Here’s what was originally there:
What is a Trauma-Informed Approach?
A program, organization, or system that is trauma-informed realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, and practices, and seeks to actively resist retraumatization.
How SAMHSA Promotes Trauma-Informed Care
Trauma-informed approaches recognize and intentionally response to the lasting adverse effects of experiencing traumatic events. SAMHSA defines a trauma-informed approach through six key principles:
Safety: participants and staff feel physically and psychologically safe.
Peer Support: peer support and mutual self-help are key vehicles for establishing safety and hope, building trust, enhancing collaboration, and utilizing their lived experience to promote recovery and healing.
Trustworthiness and Transparency: Organizational decisions are conducted with the goal of building and maintaining trust with participants and staff.
Collaboration and Mutuality: importance is placed on partnering and leveling power differences between staff and service participants.
Cultural, Historical, and Gender Issues: culture and gender-responsive services are offered while moving beyond stereotypes/biases.
Empowerment, Voice, and Choice: organizations foster a belief in the primacy of the people who are served to heal and promote recovery from trauma.
Want to take a wild guess as to which one went missing?
If you said Cultural, Historical, and Gender Issues, that’s exactly right! Check it out here.
To be clear, I did find the original six principles on an archived page in the CDC Stacks, but it’s just the infographic, and there’s a banner at the top telling you that the page is out of date and directs you to another link to another topic.
If you care about mental health, you cannot say that removing Cultural, Historical, and Gender issues is not important. It absolutely is, and it’s profoundly damaging. Yes, I know, that’s their intent. The cruelty is the point. They said so themselves. Remember when the architect of Project 2025 and current director of the Office of Management and Budget said he wanted to put people in trauma? They want to punish everyone who’s not like them. They’re attempting to erase the lived experience of people who have been traumatized by racism and gender-based hate.
We’re living through a wave of cruelty, willful ignorance, and destruction that is most definitely familiar to people who have been harmed by racism and misogyny. These are unprecedented times in that the broader population is now experiencing what minorities have for centuries. The more work I do to raise awareness about complex PTSD, the more I see how deep that damage runs in this country. Because of the stigma around mental health, there are a lot of people out there who have never even considered the idea of looking inward, and I often wonder what the world would look like if they did. And I mean digging deep, not some “download this app and you’ll be healed in 30 days challenge.”
This is political because it’s a government resource, and it took decades of advocacy to make those resources available. Trauma-informed care is essential, and it’s very much a health equity issue, which is of course why they eliminated it. Everything about it is on their list of forbidden words and concepts.
I know—there’s a lot going on now and we can argue about priorities and what to focus on until the cows come home. But they said it themselves: “We want to put them in trauma.” People who have been living with trauma are enduring more and more, and those who thought it could never happen to them are finding out that it can happen to them. We see it every day in tearful posts of people who are losing everything under this administration.
It’s important. It’s political. And someday, when we have the opportunity to build something new after the wreckage caused by this administration, trauma-informed policies should be centered for the benefit of all.