Youth involved in public sector services for substance use and other forms of mental health, juvenile justice, foster care, or homelessness report higher rates of trauma compared to the general youth population. We interviewed 26 youth, ages 14–21, with lived experience in public systems of care for the purpose of a state-contracted needs assessment evaluation. Qualitative analysis of these data indicated trauma occurs sequentially vis-à-vis the system of care. Participants experienced family adversity and a lack of social support, which has been defined as pre-system trauma. Because of this pre-system trauma, youth were referred to the public sector system of care. Rather than resolving trauma, system involvement exacerbated existing trauma and introduced new forms of trauma, defined as system-based trauma. Existing policies and practice address pre-system trauma, though there is room for improvement for both pre-system and system-based trauma. The field has yet to reckon fully with system-based trauma and this may be the next transformation for public sector youth services.

中文翻译：

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“在体制内生活真的很困难，而且……我不希望任何人都这样。”创伤和公共部门青少年护理系统

与一般青年人口相比，参与药物滥用和其他形式的心理健康、少年司法、寄养或无家可归等公共部门服务的青年遭受创伤的比例更高。为了进行国家承包的需求评估，我们采访了 26 名年龄在 14 至 21 岁之间、具有公共护理系统生活经验的青少年。这些数据的定性分析表明创伤是按护理系统顺序发生的。参与者经历了家庭逆境和缺乏社会支持，这被定义为系统前创伤。由于这种系统前的创伤，青少年被转介到公共部门的护理系统。系统的参与并没有解决创伤，而是加剧了现有的创伤，并引入了新形式的创伤，定义为基于系统的创伤。现有的政策和实践解决的是系统前的创伤，尽管系统前的创伤和基于系统的创伤都有改进的空间。该领域尚未充分考虑基于系统的创伤，这可能是公共部门青年服务的下一个转型。