By Caroline Harroe (Harmless CEO)
For thirty-three years, I have lived in a world where the floor can turn into water without warning. That is the nature of Complex PTSD. It isn’t just a ‘memory of a bad thing’; it is a physiological rewiring – a body that insists it is still in the room where the tragedy happened, even while I am simply making school lunches for my five neurodivergent children.
I am strong and I am bold, but I am weary of a system that treats trauma like a footnote in a general mental health file.
The Rising Tide
We are told that trauma is a ‘hidden epidemic’, but the numbers are increasingly visible. In the UK, recent data suggests that nearly 1 in 13 young people will develop PTSD by age 18. Across the general population, the prevalence of PTSD has risen from 4.4% in 2014 to 5.7% in 2024.
In England alone, an estimated 16.2 million adults have experienced at least one major trauma; the economic burden of this trauma is estimated at over £40billion. We aren’t a niche group; we are a significant portion of the human experience. Yet, the help available remains a ghost in the machine.
The ‘Absorbed’ Pathway: A Critique of Care
When we enquired about local pathways for PTSD specialist services, we were met with a terrifying vagueness. We weren’t given a map; we were told that patients are ‘absorbed into general mental health pathways’.
In clinical terms, ‘absorbed’ is a polite way of saying ‘lost’. When you absorb trauma into a general pathway, you lose the ability to track how much is being spent on specialist help. You lose the specific numbers of those impacted. Most importantly, you lose the nuance required to treat a condition that NICE (National Institute for Health and Care Excellence) explicitly states requires ‘trauma-focused’ interventions – specifically TF-CBT or EMDR.
The current system is a funnel with a blocked end. People with complex trauma are often shunted between services that claim they aren’t ‘complex enough’ or, conversely, ‘too complex’ for their remit. We are left in a waiting room that has no door, in short-term treatments never designed to treat the complex neurological change that occurs with trauma.
Trauma-Informed vs. Trauma-Intervention
Lately, the term ‘trauma-informed’ is being bandied about like a corporate buzzword. It’s become a piece of linguistic propaganda.
Let’s be clear: being trauma-informed is the bare minimum. It means having an awareness that trauma exists and trying not to re-traumatise people during an interaction. It is a mindset, a culture. It is not a treatment.
It is like being ‘fire-informed’ – you know that fire is hot and you’ve cleared the exits, but you don’t actually have a hose to put out the flames. Evidence-based trauma interventions are the hose. We need clinicians trained in the surgical precision of trauma recovery, not just a system that is ‘aware’ of our pain while doing nothing to alleviate it.
The Birth of Fearless
Ten years ago, I began a quiet rebellion. I spoke to fellow survivors, clinical researchers, and those working on the front lines of suicide prevention. I refined the idea until it was sharp.
We have been doing this work under the radar within the walls of Harmless, listening to the clients the system couldn’t see. And now, we are launching Fearless.
- Location: Based in the East Midlands.
- The Scope: Currently small, private and unfunded.
- The Mission: To provide the specific, evidence-based specialist help that ‘absorption’ denies us.
Fearless isn’t just a name; it’s a requirement. It takes a certain kind of fearlessness to look at a broken system and decide to build a better one from the ground up. We are starting small, but we are starting with the right people – people who understand that trauma isn’t a narrative of ‘what’s wrong with you’, but a deep, lived understanding of ‘what happened to you’.
For those of you walking the long, exhausting path in the wake of trauma: we see you. We aren’t just informed about your pain; we are fighting for your right to be treated for it.
