Collaborative care interventions in general trauma patients.

Collaborative care is a disease management strategy that aims to simultaneously target medical/surgical (eg, physical injury) and psychiatric (eg, posttraumatic stress disorder [PTSD] and depression) conditions. Collaborative care interventions hold promise for the delivery of mental health interventions in acute care as they can incorporate frontline trauma center providers, such as social workers and nurses, into early mental health services delivery and can link trauma center care to outpatient services. Initial randomized clinical trial evidence suggests that collaborative care interventions that incorporate evidence-based motivational interviewing targeting alcohol use, as well as pharmacotherapy and psychotherapy targeting PTSD, may reduce both alcohol and PTSD symptoms among injured trauma surgery patients. Trials conducted to date thus suggest that early mental health interventions can be feasibly and effectively delivered from trauma centers. Future collaborative care investigations that refine routine acute care treatment procedures and target acute care policy mandates can improve the quality of mental health care for Americans injured in the wake of individual and mass trauma.