Assessing Service Quality and Access in Trauma Centers through Behavioral Health Screening, Education, and Treatment after Pediatric Injury
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Read the article on jpedsurg.org ↗Article · Jan 2022 · 1 min read
In brief
In brief
Survey of 83 U.S. pediatric trauma centers reveals inconsistent behavioral health screening practices despite ACS COT recommendations, with only 46% screening children and 18% screening families for post-injury psychological distress. While providers rate screening as highly important, lack of standardized protocols creates access gaps for the ~20% of injured children who develop PTSD, ASD, or depression.
Written by the GCMD Library team from the article.
Background
Over 120,000 U.S. children are hospitalized annually for traumatic injury, with approximately 20% developing acute stress disorder (ASD), posttraumatic stress disorder (PTSD), or depression. The ACS COT recommends that trauma centers address emotional recovery after injury; however, few pediatric trauma centers (PTCs) assess behavioral health symptoms. This study describes results from a survey with PTC providers assessing the landscape of behavioral health screening, education, and treatment.
Methods
Trauma program leaders from 83 US Level I and II trauma centers across 36 states completed a survey assessing center characteristics and decision-making, availability, and perceptions of behavioral health resources.
Results
Nearly half (46%) of centers provide behavioral health screens for pediatric patients, and 18% screen family members, with screens mostly conducted by nurses or social workers for ASD or PTSD. Two-thirds provide child behavioral health education and 47% provide education to caregivers/family. Two-thirds provide treatment connections, typically via referrals or outpatient clinics. Behavioral health screening, education, and treatment connections were rated as very important (M > 8.5/10), with higher ratings for the importance of screening children versus caregivers. Child maltreatment (59%), observed patient distress (53%), child substance use (52%), injury mechanism (42%) and severity (42%) were prioritized in screening decision-making.
Conclusion
Service provision varies by method, resource, and provider, highlighting the lack of a roadmap for centers to provide behavioral health services. Adoption of universal education and screening procedures in PTCs is crucial to increase access to services for injured children and caregivers. PTCs are well-positioned to offer these services.