Citation

Davidson TM, Espeleta HC, Ridings LE, Witcraft S, Bravoco O, Higgins K, Houchins R, Kitchens D, Manning B, Jones S, Crookes B, Hanson R, Ruggiero KJ. J. Am. Coll. Surg. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, American College of Surgeons, Publisher Elsevier Publishing)

DOI

10.1097/XCS.0000000000000862

PMID

37815166

Abstract

BACKGROUND: Annually, over 600,000 adults served in U.S. trauma centers (≥ 20%) develop posttraumatic stress disorder (PTSD) and/or depression in the first year after injury. American College of Surgeons guidelines include screening and addressing mental health recovery in trauma centers. Yet, many trauma centers do not monitor and address mental health recovery, and it is a priority to learn how to implement evidence-informed mental health programs in trauma centers. STUDY DESIGN: This paper describes our application of the Exploration, Preparation, Implementation, Sustainment 15 model to implement the Trauma Resilience and Recovery Program (TRRP) in three Level I-II trauma centers to address patients' mental health needs. TRRP is a scalable and sustainable stepped model of care - one of the few in the US - that provides early intervention and direct services after traumatic injury.

RESULTS: Trauma centers are well-positioned to accelerate mental health recovery via early identification, education, screening, and referrals to mental health agencies that provide best-practice care. We found that TRRP was acceptable to our three partnering trauma centers. Engaging patient, provider, and hospital administration stakeholders early in the implementation process enhanced buy-in during the early stages of implementation and promoted sustainability. Active processes to support monitoring, evaluation, and adaptation were critical.

CONCLUSIONS: Our work demonstrates the feasibility of implementing and adapting TRRP, a cost-efficient and sustainable stepped care intervention, in Level I and II trauma centers. Several factors should be carefully considered by trauma centers seeking to integrate behavioral health interventions into their trauma program.

Language: en