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Mental Health Screening in a Rural Trauma Center: Feasibility and Impact.

Tessa C Savell1, Alexa L Peterson, Ryan P Carroll

  • 1Author Affiliations: Trauma Services, Billings Clinic, Billings, Montana (Mrs Savell, Mrs Peterson, Mr Carroll, Mr Orr, and Mr Palm); Trauma & Critical Care Surgery, Billings Clinic, Billings, Montana (Dr Englehart); and Collaborative Science & Innovation, Billings Clinic, Billings, Montana (Dr Thompson).

Journal of Trauma Nursing : the Official Journal of the Society of Trauma Nurses
|July 9, 2025
PubMed
Summary

Mental health screening is feasible in rural trauma centers, with 84.2% compliance achieved. However, only 10.8% of positive screens led to consultations, indicating persistent barriers to care for trauma survivors.

Keywords:
FeasibilityInjured Trauma Survivor Screen (ITSS)Mental healthMental health screeningRural trauma centerTraumaTrauma quality improvement

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Area of Science:

  • Trauma care
  • Mental health services
  • Rural health

Background:

  • Trauma survivors frequently experience psychological issues like depression and PTSD.
  • Rural trauma centers face challenges in identifying and treating at-risk patients due to limited resources.
  • A gap exists in literature addressing mental health screening in rural trauma settings.

Purpose of the Study:

  • To evaluate the feasibility of implementing a mental health screening initiative in a rural trauma center.
  • To assess the impact of this initiative on screening compliance, resource provision, and psychiatric consultation rates.

Main Methods:

  • A quasi-experimental design was employed over two years (2022-2024) at a rural Level II trauma center.
  • Screening compliance, resource provision, and psychiatric consultation rates were compared between implementation and post-implementation periods.
  • Eligible trauma patients (≥18 years, GCS > 14, admitted ≥2 days) were included, targeting ≥80% screening compliance.

Main Results:

  • 84.2% of 1,114 eligible patients were screened, exceeding the 80% target.
  • 33.5% of screened patients tested positive for psychological sequelae.
  • Missed screening opportunities decreased from 20.5% to 13.6% (p=0.022), but only 10.8% of positive screens resulted in formal psychiatric evaluations.

Conclusions:

  • Mental health screening is feasible in rural trauma settings, achieving high compliance rates.
  • The initiative demonstrated a reduction in missed screening opportunities.
  • Significant systemic barriers hinder the translation of positive mental health screens into formal psychiatric consultations for trauma patients.