Psychological and Psychosocial aspects of major trauma care: a survey of current practice across UK and Ireland

Abstract

Introduction
Psychological and psychosocial impacts of major trauma, defined as any injury that has the potential to be life-threatening and/or life changing, are common, far-reaching, and often enduring. There is evidence that these aspects of major trauma care are often underserved. The aim of this research was to gain insight into current provision and operationalisation of psychological and psychosocial aspects of major trauma care across the UK and Ireland.

Methods:
A cross-sectional online survey, open to health professionals working in major trauma network hospitals was undertaken. The survey had sixty-nine questions across six sections: Participant Demographics, Psychological First Aid (PFA), Psychosocial Assessment and Care, Assessing and Responding to Distress, Clinical Psychology Services, and Major Trauma Keyworker (Coordinator) Role.

Results:
There were 102 respondents from across the regions and from a range of professional groups. Survey findings indicate a lack of formalised systems to assess, respond and evaluate psychological and psychosocial aspects of major trauma care, most notably for patients with lower level distress and psychosocial support needs, and for trauma populations that don’t reach threshold for serious injury or complex health need. The findings highlight the role of major trauma keyworkers (coordinators) in psychosocial aspects of care and that although major trauma clinical psychology services are increasingly embedded, many lack capacity to meet demand.

Conclusion:
Neglecting psychological and psychosocial aspects of major trauma care may extend peritraumatic distress, result in preventable Years Lived with Disability and widen post-trauma health inequalities. A stepped psychological and psychosocial care pathway for major trauma patients and their families from the point of injury and continuing as they move through services towards recovery is needed. Research to fulfil knowledge gaps to develop and implement such a model for major trauma populations should be prioritised along with development of corresponding service specifications for providers.