Implementation of a Stepped Care Program to Address Emotional Recovery among Traumatic Injury Patients.

Area of Science:

• Trauma surgery
• Mental health services research
• Health services implementation

Background:

• Over 600,000 adults in US trauma centers develop PTSD or depression annually.
• American College of Surgeons guidelines recommend mental health screening and care in trauma centers.
• Many trauma centers lack systems to monitor and address mental health recovery post-injury.

Purpose of the Study:

• To describe the implementation of the Trauma Resilience and Recovery Program (TRRP) in trauma centers.
• To assess the feasibility and sustainability of a stepped care model for mental health in trauma patients.

Main Methods:

• Applied the Exploration, Preparation, Implementation, Sustainment (EPIS) model.
• Implemented the TRRP, a scalable, sustainable, stepped model of care.
• Focused on early intervention and direct services for patients after traumatic injury.

Main Results:

• TRRP was found to be acceptable to three Level I and II trauma centers.
• Early engagement of patients, providers, and administration enhanced buy-in and sustainability.
• Active monitoring, evaluation, and adaptation processes were critical for success.

Conclusions:

• Demonstrated the feasibility of implementing and adapting TRRP in trauma centers.
• TRRP is a cost-efficient and sustainable stepped care intervention.
• Trauma centers must carefully consider factors for integrating behavioral health interventions.