Screening and Intervention for Mental Health Disorders and Substance Use and Misuse in the Acute Trauma Patient

Publication Date: January 10, 2023
Last Updated: January 31, 2023

Key Points

Substance Misuse & Intervention

  • Resilience, recovery, delayed onset, and chronic distress are the four major trajectories of mental health wellness following trauma.
  • Trauma-informed care is a care approach intended to improve patient engagement, adherence to best practices for treatment, and patient outcomes.
  • Population-based studies suggest that mental health and substance use disorders work in a combined manner to increase the risk of a patient’s recurrent hospitalization and mortality after an index injury.
  • Alcohol and substance use problems are prevalent and increasing among trauma patients. They are associated with increased mortality, complications, need for critical care, increased length of stay, and cost of care.
  • Trauma centers participate in nationwide screening and intervention programs for substance use problems.
  • Screening and intervention programs improve outcomes related to substance use problems.
  • A best practice is to have an SBIRT clinician, someone with patient care responsibilities who has been given extra training in screening, brief intervention, or both.
  • Clinical supervision resources include someone with additional training and expertise in psychology or psychiatry.
  • Each trauma center develops a written policy and procedure for SBIRT service provision within their health system as a best practice.
  • Develop a therapeutic rapport with the patient prior to the screening questions to improve the outcomes with the SBIRT screening process.
  • Harm reduction intervention, often a focus of brief interventions in trauma centers, is an evidence-based practice for reducing substance use and related harms that does not require complete abstinence.
  • Medication-assisted therapy, plus behavioral treatment or counseling, is increasingly recognized as a best practice intervention for opioid use disorder.
  • A diagnosed substance use disorder is chronic, and relapse is common.



Screening and Intervention for Mental Health Disorders and Substance Use and Misuse in the Acute Trauma Patient

Authoring Organizations