Each year more than 2 million people are hospitalized after suffering a very serious injury resulting from car crashes, motorcycle accidents, and pedestrian incidents, along with people who have been shot or stabbed. According to Ken Ruggiero, Ph.D., national estimates show that 20 to 40 percent of that population develops significant symptoms of PTSD and depression in the first year after their injury.
Ruggiero is the director of MUSC's Telehealth Resilience and Recovery Program (TRRP) and a professor in the College of Nursing. Tatiana Davidson, PhD, also on the College of Nursing faculty, is TRRP’s Co-Director. TRRP is designed to catch trauma patients early and screen them for PTSD and depression. The TRRP team focuses on patients still in the hospital who have experienced a traumatic injury to educate them about emotional recovery after traumatic injury and tell them about the program. If the patient agrees, they will receive a follow-up phone screen for PTSD and depression one month after they’ve been discharged. Patients who screen positive are offered formal treatment. Patients use iPads, computers, smartphones, or other electronic devices to connect them with PTSD specialists while recovering in their home. (The program supplies iPads to people who need them.)
Launched in September of 2015, the College of Nursing led program has grown significantly and their innovative, scalable approach to addressing patients’ mental health needs after traumatic injury has been getting increased attention. The TRRP team has made quite an impact in SC.
In its second year, TRRP has approached and educated around 500 patients at an MUSC Health hospital, with 282 of those patients completing a 30-day mental health screen over the phone, which led to 106 recommendations to connect to a mental health provider.
Data from the 30-day telephone screens suggested a high prevalence of PTSD and depression. Although the team did not see meaningful differences by age group, they did see differences in risk for PTSD and depression by race and gender. Women were more likely than men to screen positive for PTSD or depression at the 30-day phone call, and African Americans were more likely than white patients to screen positive. Most patients who screened positive for PTSD and/or depression during the 30-day screen accepted recommendations for assessment and treatment (34 percent of patients declined assessment and treatment services).
Ruggiero, who is also the co-director of the Technology Applications Center for Healthful Lifestyles (TACHL), estimates that in the program's first two years, the team has served more than 1,000 patients who would not have received any mental health services under the old model. "Although we view this as a success, we also view it as only the first step in the process. The next step is to expand the program and explore how to adapt and implement it in other trauma centers across South Carolina," he said.
In July, TRRP secured a three-year award from the Duke Endowment grant to expand the program across the state. With support and partnership from the MUSC Health Center for Telehealth, the program will include three other trauma centers in South Carolina. Its first two partners will be Palmetto Health and Trident Medical Center.
Colleagues at TACHL are currently testing a tablet-based patient portal that can be used at MUSC and our partnering trauma centers that will dramatically increase the efficiency of the program and reduce staff burden.
Olivia Eilers, program coordinator for TRRP, said it’s important for trauma survivors and their loved ones to know what to expect emotionally after an injury. “We see a lot of patients who aren’t prepared for the emotional trauma because the focus is so much on healing physically," she said. "Emotional health is just as important. As a community, we need to keep working to reduce stigma around mental health by providing the right resources and continually letting people know it’s ok to ask for help.”