In October 2010, the U. S. Substance Abuse and Mental Health Services Administration (SAMHSA) awarded the State of Delaware a five-year, $3.6 million, Mental Health Transformation Grant (MHTG). The goal of the grant is to support system change: to create a Trauma-Informed system of care throughout Delaware. The Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. (aka DSM-IV, American Psychiatric Association, 1994) defines trauma as an experience in which one is, "threatened with death or serious injury directly". Other examples of life events that may be experienced as traumatic by individuals include, but are not limited to; sexual abuse, severe neglect, physical abuse, domestic violence, witnessing violence and cruelty to others, deprivation due to extreme poverty, serious emotional and psychological abuse, gang and drug related violence, repeated abandonment and sudden loss.

To develop a system of care that is Trauma-Informed requires that all aspects of the system have knowledge of the prevalence of trauma, the impact that traumatic life events have on human beings, and how these affect recovery. It is estimated that, "90% of public mental health clients have been exposed to trauma," (Mueser et al., 1998; Mueser et al., 2004), and that most have experienced trauma multiple times. A Trauma-Informed system should minimize "re-traumatization", and work to empower trauma survivors. The first steps will include statewide trainings focusing on imparting knowledge on systems of care that are trauma informed in addition to the hiring of Trauma Specialists to work in each site with clinicians and clients. These specialists will focus on select clinics or agencies each year over the next five years of the grant.

Year one will focus on training and staffing the State's Community Mental Health Centers in each county. The following years will focus on the Community Continuum of Care Programs (CCCP) which provide an intensive and integrated community-based recovery approach, and agencies that serve people with addictions. One of the objectives of the Trauma Specialists is to teach each site how to provide Trauma-Informed care by assisting with screening, assessing and developing treatment plans for trauma survivors. The grant also supports the initial hiring and training of Peer Specialists, people that have lived experiences of mental illness and/or addiction recovery, that will serve as recovery resource people for clients within the participating agencies. The Peer Specialists will work in all of the participating sites with a total of 30 peers being trained in trauma informed care over the course of the grant. The Peer and Trauma Specialists will receive clinical supervision to assist in reporting the sites' progress toward system change and providing consultation on trauma-informed care and supervision.