Utilization of mental health services in pediatric patients surviving penetrating trauma resulting from interpersonal violence

Abstract

Background: Violent trauma has lasting psychological impacts. Our institution's Community Violence Response Team (CVRT) offers mental health services to trauma victims. We characterized implementation and determined factors associated with utilization by pediatric survivors of interpersonal violencerelated penetrating trauma. Methods: Analysis included survivors (0e21 years) of violent penetrating injury at our institution (2011 e2017). Injury and demographic data were collected. Nonparametric regression models determined factors associated with utilization. Results: There was initial rapid uptake of CVRT (2011e2013) after which it plateaued, serving >80% of eligible patients (2017). White race and higher injury severity were associated with receipt and duration of services. In post-hoc analysis, race was found to be associated with continued treatment but not with initial consultation. Conclusion: Successful implementation required three years, aiding >80% of patients. CVRT is a blueprint to strengthen existing violence intervention programs. Efforts should be made to ensure that barriers to providing care, including those related to race, are overcome. Published by Elsevier Inc. * This study describes the utilization of mental health services amongst pediatric survivors of penetrating trauma resulting from interpersonal violence through a novel program: The Community Violence Response Team. This study reports the successful implementation of this unique program and highlights the importance of providing mental health services to vulnerable victims of violence.

Changing epidemiology of firearm injury: a cohort study of non-fatal firearm victimisation before and during the COVID-19 pandemic, Indianapolis, Indiana

“…Older adults are more likely to be connected with a primary care provider, whom should use this opportunity to connect victims with mental health services 35. Posthospital discharge care programmes provide ongoing mental health services outside of the managed care system and follows up weekly with patients36 and demonstrates an increase in mental health utilisation among paediatric patients. Such a programme should expand outreach to all victims, particularly female and older victims, to better connect them with needed services postinjury.…”

Healthcare utilization and mental health outcomes among nonfatal shooting assault victims

“…Pulcini and colleagues observed a similar decrease post injury mental health visits among youth but reasons for the decrease in mental health utilization post injury remains unclear ( Pulcini et al, 2021 ). Such age disparities may speak to access to mental health services and parental decision making regarding when and if youth are connected to mental health services ( Neufeld et al, 2021 ), as parents report not knowing when their child may need such services ( Bringewatt and Gershoff, 2010 ). Whereas older victims are more likely to suffer from anxiety, depression and bipolar disorder ( CfDCaPaNAoCD, 2008 ), and other chronic conditions ( Maccarrone et al, 2021 ), and therefore may be connected with a healthcare provider for needed services post NFS.…”

“…For example, a Community Violence Response Team (CVRT), works in conjunction with the HVIP but focuses on providing free, ongoing mental health services outside the managed care system and follow up continues weekly until the patient engages in care or requests the follow up be stopped. Evaluation of the CVTR indicates an increase in mental health services and continued utilization for three-fourths of pediatric patients aged 0–21 years ( Neufeld et al, 2021 ).…”

History repeats itself: Impact of mental illness on violent reinjury and hospital reencounters among female victims of interpersonal violence

“…Services, carried out by Masters-level mental health clinicians, are voluntary, offered independent of insurance, free, and can continue. 27 While many institutions have active HVIPs, programming could be extended to increase the focus on mental health. Using CVRT as a model, embedding mental health care directly into the trauma service and the care of the trauma patient may serve to increase patients' access to mental health services after violent injury.…”