Understanding
Iatrogenic Trauma
iPTSD.org
Introduction
Iatrogenic trauma is trauma caused inadvertently by the treatments themselves, like medication side-effects, surgical procedures, diagnostic errors, and other non-pharmacological interventions. Trauma that occurs because of intentional actions (or omissions) of the provider is typically considered a crime and would not be described as iatrogenic. Iatrogenic trauma can contribute to system-induced or institutional trauma.
Therapeutic Missteps
Breaches in the therapeutic relationship, leading to a lack of trust or feeling invalidated.
Systemic Failures
Issues like bureaucratic hurdles and unnecessary requirements in social services that indirectly cause distress.
Inappropriate Techniques
Misapplication of techniques or correct application of the wrong techniques for the client’s needs or background.
Ethical Violations
Confidentiality breaches, perverse incentives, and dual relationships can harm client well-being.
Recognizing iatrogenic trauma in mental health and social services involves understanding the delicate balance between intervention and the potential for unintended harm
BMJ. “Sarah Markham: Dealing with Iatrogenic Harm in Mental Health.” The BMJ, December 4, 2018. https://blogs.bmj.com/bmj/2018/12/04/sarah-markham-dealing-with-iatrogenic-harm-in-mental-health/.
SIGNS & SYMPTOMS OF IATROGENIC TRAUMA
Identifying iatrogenic trauma involves recognizing patterns and practices in healthcare that inadvertently lead to patient harm or distress, particularly affecting those most vulnerable. Key indicators to monitor include:
unintended concequences
Treatments or interventions that result in negative outcomes, affecting patients' physical or psychological well-being beyond the intended scope of care.
DISMISSAL OF PATIENT EXPERIENCE
Healthcare professionals ignoring or invalidating patients' reported experiences of treatment-related distress or side effects.
PATIENT BLAMING
Attributing complications or poor outcomes to the patient’s actions or characteristics, rather than acknowledging the role of the treatment or intervention.
LACK OF INFORMED CONSENT
Patients or their legal guardians are not adequately informed about the potential risks and side effects of treatments, leading to unexpected harm.
ONE-SIZE-FITS-ALL APPROACH
Standardized treatment protocols that don’t account for individual patient differences, potentially resulting in adverse effects or ineffective care.
OVER-MEDICALIZATION
The practice of treating non-medical issues as medical problems, or non-psychiatric problems as psychiatric problems, leading to unnecessary interventions that can cause harm.
ETHICAL BREACHES
Violations of ethical standards in healthcare, such as confidentiality breaches or dual relationships, leading to psychological harm.
BREAKDOWN IN COMMUNICATION
Poor communication between healthcare providers and patients, leading to misunderstandings and mistakes in the delivery of care.
INSUFFICIENT FOLLOW-UP
A lack of proper follow-up care to monitor for and address any adverse reactions from treatment.
SIDE-EFFECT DENIAL
A tendency to downplay or ignore the side effects of treatments, or to attribute symptoms to underlying patient conditions rather than treatment effects.
Preventing Iatrogenic Harm
Preventing iatrogenic harm involves proactive communication, education, and advocacy. Here are some steps they can take:
Stay Informed
Ask Questions
Learn about any treatments or medications you’re prescribed. Understand the risks and benefits, and how they might affect you.
Don't hesitate to ask your healthcare providers to explain anything you don’t understand about your care.
Be Honest
Be sure to give your healthcare team all the information about your health history, allergies, and any other treatments or medications you're taking
Follow Your Treatment Plan
Stick to the treatment and medication schedule your healthcare provider has given you, unless you experience issues.
Know Your Rights
Speak Up
You have rights as a patient, including the right to privacy and informed consent. Be aware of these rights and don't be afraid to exercise them.
If you're feeling unwell or notice side effects, let your healthcare providers know immediately.
Seek a Second Opinion
If you're unsure about a recommended treatment, it’s okay to seek a second opinion from another healthcare professional.
Involve an Advocate
Have a friend (or, if you're a minor, a parent, guardian, or another trusted adult) with you during medical or mental health appointments to help ask questions and make decisions.
Monitor Your Health
Pay attention to how you're feeling during and after treatment. Keep a diary of any changes and discuss these with your healthcare provider.
Learn to Advocate for Yourself
Understand that you can and should speak up for yourself in healthcare settings. Know what you need, and communicate your needs clearly and respectfully.