Mental Health Screening And Follow Up In Pediatric Trauma Centers: A National Survey Of 82 Centers And Mixed Methods Evaluation
*Leigh E. Ridings1, Hannah C Espeleta1, Olivia Bravoco1, Tatiana Davidson1, Nicole Litvitsky1, *Nancy Kassam-Adams2, *Christian Streck1, Kenneth Ruggiero1
1Medical University of South Carolina, Charleston, SC;2Children's Hospital of Philadelphia, Philadelphia, PA
Background: Each year, 300,000 US children are hospitalized for traumatic injury, elevating risk for development of mental health problems. However, many pediatric trauma centers (PTCs) do not provide routine mental health screening or intervention after pediatric traumatic injury (PTI). The objective of this mixed-methods study was to assess the availability and implementation of mental health resources and follow-up services in PTCs for children and their caregivers after PTI. Methods: Quantitative survey data were collected from 82 Level I (75%) and Level II (25%) PTCs serving traumatically injured children from 36 states. Pediatric Trauma Program Managers and Coordinators completed the survey. Semi-structured, qualitative interviews were conducted with a purposive sample of participants (N=24) to better understand feasibility and current practices in implementing mental health education, screening, and treatment for PTI patients and caregivers. Results: The majority of PTC’s had a psychiatrist and psychologist on staff (63%), with Level I centers more likely to have both (χ2 = 9.3, p = .05). We found that only 46% of centers used mental health screening protocols and 61% routinely provided some mental health education. PTC’s frequently leveraged social workers and nursing staff to complete screening and education. Finally, 55% reported facilitating mental health referrals for children and families. Participants perceived mental health screening, education, and treatment as very important for children and their family members following a PTI. Conclusions: Future research should work to develop sustainable, scalable resources that have the potential for uptake in PTCs to improve quality and access to services after traumatic injury.
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