CODE Staff’s Trauma-Informed Care Supports HIV/AIDS Patients

Staff of RSDM’s Community Oriented Dental Education (CODE) program clinics.

You don’t need to know a patient’s history to practice trauma-informed care, according to Dr. Jill York, Assistant Dean for Extra Mural Clinics, who runs RSDM’s Community-Oriented Dental Education (CODE) program.

The large and small acts of concern and sensitivity staff and providers have integrated into the South Jersey clinics can make everyone feel comfortable and welcome. “Our approach is not to be social workers or psychologists but to have it be a philosophy that governs all of our actions,’’ she explained.

The approach is especially valuable for the nearly 600 HIV/AIDS patients who visit the three CODE sites, which receive federal Ryan White funding and treat additional underserved patients as well.

“These patients are already fighting one battle, the AIDs epidemic, and that comes with its own trauma,’’ said expanded duty dental hygienist Darlene Saggiomo, who is a member of RSDM’s Ryan White Executive Council and works in CODE’s Somerdale and Northfield offices. CODE has an additional site in Galloway.

The pandemic has made it even more difficult for HIV/AIDS patients to cope, especially because many are immunocompromised. “It created so many life changes. Some also lost family members, some lost their partners, their jobs,’’ said Saggiomo.

In 2018, RSDM CODE staff joined the New Jersey Department of Health’s Trauma Informed Care Project to build a strategy that ensures patients feel safe and understood. While staffers always prided themselves on their compassion and efforts to create a welcoming environment, the state-designed training allowed them to be more systematic about it.

“Now, we’re all on the same page,’’ said Saggiomo.

Methods the clinic uses to help trauma survivors include posting hotlines numbers for domestic violence and depression on walls throughout the office so patients who feel endangered asking for help or bringing home a pamphlet can take a screenshot on their phone.

If a patient is late for an appointment or has an emotional response to something that might seem like a small annoyance, having to wait longer than usual, for instance, staff know that underlying problems might be the reason. “Instead of having an attitude like they’re overreacting or blaming them,  you say, “What happened? Is everything ok?’’ explained Dr. York.

The clinic staff doesn’t stop at providing oral healthcare, said Saggiomo. They connect patients with resources to help them find housing and food, as well as medical and psychological care. Sometimes, they flag health problems that might have gone undetected otherwise.

When one patient’s high blood pressure reading didn’t subside after she had time to sit quietly, Saggiomo sent her immediately to a doctor who found she was at high risk for heart attack.

“We treat the whole person, not just their mouth,’’ said Saggiomo.

Recently, the CODE staff’s trauma-informed care efforts, and other clinical success stories, were featured in the biennial report of the U.S. Department of Health and Human Services Administration HIV/AIDS Bureau.

The staff is glad to be recognized. But patient feedback means the most.

“When we surveyed patients and ask why they stay with us and keep coming back, they say, “Because you care,’’ said Dr. York.