Eileen M Bulger1,2, Peyton Johnson3, Lea Parker3,4, Kathleen E Moloney3, Michelle K Roberts3,5,6, Natalie Vaziri3, Sara Seo3, Deepika Nehra1, Peter Thomas7, Douglas Zatzick3,2. 1. From the Department of Surgery (Bulger, Nehra), University of Washington School of Medicine, Seattle, WA. 2. Harborview Injury Prevention and Research Center (Bulger, Zatzick), University of Washington School of Medicine, Seattle, WA. 3. Department of Psychiatry and Behavioral Sciences (Johnson, Parker, Moloney, Roberts, Vaziri, Seo, Zatzick), University of Washington School of Medicine, Seattle, WA. 4. Department of Psychology, Drexel University College of Arts and Sciences, Philadelphia, PA (Parker). 5. Department of Rehabilitation Medicine (Roberts), University of Washington School of Medicine, Seattle, WA. 6. Department of Anthropology, University of Kentucky College of Arts and Sciences, Lexington, KY (Roberts). 7. Powers Pyles Sutter & Verville PC, Washington, DC (Thomas).
Abstract
BACKGROUND: Posttraumatic stress disorder (PTSD) symptoms, firearm violence events, alcohol and drug use problems, and major depression and suicidal ideation are endemic among patients admitted to US trauma centers. Despite increasing policy importance, the current availability of screening and intervention services for this constellation of conditions in US trauma centers is unknown. STUDY DESIGN: Trauma program staff at all Level I and Level II trauma centers in the US. (N = 627) were contacted to complete a survey describing screening and intervention procedures for alcohol and drug use problems, PTSD symptoms, depression and suicidality, and firearm violence. Additional questions asked trauma centers about the delivery of peer interventions and information technology capacity for screening and intervention procedures. RESULTS: Fifty-one percent of trauma centers (n = 322) responded to the survey. More than 95% of responding sites endorsed routinely screening and/or intervening for alcohol use problems. Routine services addressing PTSD were less common, with 28% of centers reporting routine screening. More than 50% of sites that screened for PTSD used previously established trauma center alcohol use services. Programmatic screening and intervention for firearm injury sequelae was occurring at 30% of sites. CONCLUSION: Alcohol screening and intervention is occurring frequently at US trauma centers and appears to be responsive to American College of Surgeons Committee on Trauma verification requirements. Routine screening and intervention services for PTSD and firearm injury were occurring less frequently. Regular national surveys may be a key element of tracking progress in national mental health and substance use screening, intervention, and referral policy.
BACKGROUND: Posttraumatic stress disorder (PTSD) symptoms, firearm violence events, alcohol and drug use problems, and major depression and suicidal ideation are endemic among patients admitted to US trauma centers. Despite increasing policy importance, the current availability of screening and intervention services for this constellation of conditions in US trauma centers is unknown. STUDY DESIGN: Trauma program staff at all Level I and Level II trauma centers in the US. (N = 627) were contacted to complete a survey describing screening and intervention procedures for alcohol and drug use problems, PTSD symptoms, depression and suicidality, and firearm violence. Additional questions asked trauma centers about the delivery of peer interventions and information technology capacity for screening and intervention procedures. RESULTS: Fifty-one percent of trauma centers (n = 322) responded to the survey. More than 95% of responding sites endorsed routinely screening and/or intervening for alcohol use problems. Routine services addressing PTSD were less common, with 28% of centers reporting routine screening. More than 50% of sites that screened for PTSD used previously established trauma center alcohol use services. Programmatic screening and intervention for firearm injury sequelae was occurring at 30% of sites. CONCLUSION: Alcohol screening and intervention is occurring frequently at US trauma centers and appears to be responsive to American College of Surgeons Committee on Trauma verification requirements. Routine screening and intervention services for PTSD and firearm injury were occurring less frequently. Regular national surveys may be a key element of tracking progress in national mental health and substance use screening, intervention, and referral policy.
Authors: Jefferson Nguyen; Lauren K Whiteside; Eileen M Bulger; Laura Veach; Kathleen Moloney; Joan Russo; Deepika Nehra; Jin Wang; Douglas F Zatzick Journal: Trauma Surg Acute Care Open Date: 2022-08-04