Trauma, Mental Health, and Co-occurring Disorders 

Posted Jan 31, 2023

Did you know that individuals who experience trauma in their lifetime struggle with mental health disorders? These disorders may include anxiety, depression, or more serious disorders including substance use. What is trauma? Trauma is defined by the Substance Abuse and Mental Health Services Administration (SAMHSA) in the U.S. Department of Health and Human Services, as consisting of the three E’s: an event, an experience, and an adverse effect. They further define trauma as “a traumatic event, series of events, or set of circumstances that are experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual wellbeing” (2014). Trauma is a personal experience and what may be interpreted traumatic to one individual may not be seen as traumatic to another. However, trauma is a significant risk factor for nearly all behavioral health and substance use disorders.  

In 1998, Felliti, et al, performed the Adverse Childhood Experience (ACE) study, looking at various childhood traumatic events such as physical and sexual abuse, witnessing abuse and conflict, and experiencing emotional and physical neglect. The authors looked at the outcomes of these traumatic events and found a link to substance and alcohol use and mental health disorders, which also led to physical diseases later in life. Childhood trauma led to the development of disease, disability, social problems, as well as early death (Felliti, et al, 1998). In 2021, a study looking at the adverse childhood experiences by Meeker, et al, looked at the ACEs in the adolescent population. This study revealed that those who experienced two or more adverse childhood experiences were more likely to report substance use, with marijuana and alcohol being the highest reported.   

So, what do we do about the experience of trauma, and how can we help those who are suffering? The first step for healthcare providers is to always assess for trauma and trauma-related symptoms in everyone they encounter and offer help to those in need. SAMHSA (2014) recommends a “trauma-informed approach” and states that “trauma plays a role in mental and substance use disorders and should be systematically addressed in prevention, treatment, and recovery settings” (p. 9). Several screening tools may be utilized for this in a busy office. Trauma may be treated with a wide variety of therapies and medications to improve mental health and decrease substance use of those who are suffering.    

While there are many different therapies available for trauma-related disorders, prevention is key. Prevention includes promoting prenatal health, prevention of childhood abuse and trauma, teaching good parenting skills, prevention of head injuries, and the application of targeted programs to reduce child and adolescence substance use disorders (Perese, 2012).  

Many people experience various types of trauma, and everyone responds differently. Trauma can lead to a variety of mental health and substance use disorders leading to disease and premature death. Prevention is key to reducing pain and suffering. To learn more, explore the U.S. Department of Health & Human Services, SAMHSA website at  

Regina Prusinski, DNP, APRN, FNP-BC, CPNP-AC 

Nursing Graduate Director 



​​Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., . . . Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventative Medicine, 14(4), 245-248. doi:  

​Meeker, E. C.-J. (2021). The impact of adverse childhood experiences on adolescent health risk indicators in a community sample. Psychological Trauma: Theory, Research, Practice and Policy, 13(3), 302-312. doi:  

​Perese, E. F. (2012). Psychiatric advanced practice nursing: A biopsychosocial foundation for practice. F. A. Davis.  

​U.S., D. (2022). Substance Abuse and Mental Health Services Administration. Retrieved from