Should Kids With Traumatic Injuries Be Screened For Mental Health Issues? Interview with:


Dr. Leonard

Dr. Julie Leonard MD MPH
Nationwide Children’s Hospital
Columbus, OH What is the background for this study? What are the main findings?

Response: We looked at children with unintentional injuries who were hospitalized to see if there was an increase in their mental health needs. We saw an average 63% increase in mental health diagnoses and a 155% increase in medications prescribed to treat a mental illness. Was there anything surprising?

Response: Rates of mental illness in children are about 10-17% in the general population. The rates of children with mental health diagnoses within our study were comparable to this, however we were able to show that the rates were substantially increased after an injury, increasing from 9.6% to 15.7%. Are certain populations more susceptible to mental health needs after injury?

Response: This study found young children with burns and children of all ages with head injuries to be at greater risk.

Children under five years old with burns showed an increased risk of mental health diagnoses after injury. We usually think young children are resilient and they will forget about or get over a traumatic event, but this study shows that may not be the case. It’s challenging with our littlest ones who may not be able to tell us what’s wrong, but there are still signs parents and healthcare providers can watch out for, like a change in their sleeping or eating patterns.

Children of all ages who experienced traumatic brain injuries were at increased risk for mental health diagnoses after injury.  This finding is consistent with other studies that show increased mental health service utilization by children in the year following traumatic brain injury. What should readers take away from your report? 

Response: An injury event is a stressor for children. Parents and healthcare providers need to be vigilant in identifying children’s mental health needs during and after an injury event. 

While healthcare providers are experts in their field, parents are experts in their children’s behavior. If there are changes in how your child is acting – anything suspicious like changes in mood, withdrawing from friends or activities they normally enjoy, bad grades or missed homework – parents should check in with their child’s pediatrician or mental health provider.

All healthcare providers need to be aware of the increased mental health needs in children who’ve experienced a traumatic injury. Families may not always follow-up with a healthcare provider in the same network in which they were initially treated. They may go to their regular provider in the community. If a provider knows a child has experienced a traumatic injury they should screen the patient for mental health needs as part of standard follow-up care.

It’s important to understand the stressors and context of a child being treated for a serious injury. They are frequently injured in their home, a place where they usually feel safe.  They often come to the emergency department without their parents or family – their main support system. They experience a loss of control, lots of unfamiliar faces, and likely will go through testing and procedures that are new to them and may be painful or invasive. It can be a scary experience. What recommendations do you have for future research as a result of this study?

Response: This research serves as a foundation for future prospective studies to fully investigate the relationship between injury and mental health. If a causal relationship is found, the routine psychological screening of children after hospital discharge for unintentional injury can improve access to mental health resources and prevent treatment delays. Ultimately, if we can define expected mental health complications following injury in specific pediatric populations, we could pre-emptively intervene to prevent future morbidity. Is there anything else you would like to add?

Response: The authors declare no conflicts of interest. Thank you for your contribution to the community.


Mental Health after Unintentional Injury in a Pediatric Managed-Medicaid Population
Bushroe, Kylie M. et al.
The Journal of Pediatrics , Volume 0 , Issue 0

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.


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Last Updated on May 7, 2018 by Marie Benz MD FAAD