Emergency care practitioners' barriers to mental health assessment, treatment, and referral of post-injury patients

Objective: Nearly half of all severely injured patients suffer some form of post-trauma mental stress, but little is known about factors that influence emergency care practitioners' decisions to refer injured patients to mental health care services. This study aimed to: (1) advance our understanding of the practice barriers that hinder mental health assessment, treatment, and referral of injured patients in emergency care settings, and (2) determine the preferred learning format of emergency care practitioners who desire to gain knowledge about mental health problems after injury. Methods: Using a mail survey research design, data were collected from a random sample of emergency medicine physicians and nurses in Wisconsin and New York. Results: Data was provided by 108 respondents with an average of 16 years of emergency care experience. More than half indicated they never refer trauma patients for mental health follow-up. Primary reasons for not dealing with trauma-related mental health issues were insufficient time and lack of symptoms. Providers who were most satisfied with their hospital's capacity to support mental health care were significantly more likely to refer patients. The top preference for receiving additional training related to mental health needs of trauma patients was on-site lectures. Conclusion: Injured patients rely on emergency care practitioners to provide multidimensional care. However, few practitioners facilitate mental health referrals for post-trauma victims, despite their known value.