(114) ICU Trauma and Mental Health: Screening, Risk Factors, and Service Utilization

Introduction:

Introduction: Admission to intensive care units (ICU) can lead to poor mental health (MH), with psychopathology being higher at 1- and 5-year post-ICU stay relative to hospitalized and general populations (Sareen, et al., 2020). Yet, injury patients admitted to the ICU also represent a unique population given trauma reactions to both the injury and ICU stay. The aim of the current study was to evaluate rates of MH risk and engagement with MH services in injury patients with ICU compared to no-ICU stays.

Methods:

Methods: A retrospective study was conducted at a Level 1 trauma center with injured adults (N = 2776) from 2016 to 2022. The trauma center MH practice includes: 1) screening for posttraumatic stress disorder (PTSD) and depression using the Injured Trauma Survivor Screen (ITSS; Hunt et al., 2021); 2) MH consultation following positive risk screen; and 3) as-needed follow up intervention. Implementation and group comparisons (ICU vs no-ICU) in screening and consultation rates were evaluated.

Results:

Results: For ICU patients, 10.6% screened at-risk for depression, 14.6% screened at-risk for PTSD, 24.5% screened at risk for both PTSD and depression, and 50.4% screened negative. There were no significant differences in screening implementation between patients with or without ICU stays; however, 17.7% were not screened. ICU patients who were not screened had greater injury severity (t(1145) = 6.48, p<.001) and longer lengths of stay (t(1147) = 7.83, p<.001). It took longer (M=6.85 days, SD=10.06) to complete a MH consult for ICU patients (t(1307)=-9.84, p<.001) and consults were shorter (t(1302) = 3.38, p<.001), yet ICU patients had more follow ups (t(1323) = -6.438, p<.001) and total time (t(1292) = 3.46, p<.001) with MH providers.

Conclusions:

Conclusion: ICU stays can be distressing and lead to psychopathology. At our trauma center, most ICU patients were screened, with nearly half identified as being at risk and they engaged with more mental health services. However, a critical gap remains in ensuring equitable referrals for all patients, especially those with significant physical injuries, as initial treatment focuses first on survival and may miss MH needs later. Addressing these disparities is essential to ensure that all patients receive comprehensive care.