Symposia
Trauma and Stressor Related Disorders and Disasters
Yulia Gavrilova, Ph.D.
Medical University of South Carolina
Charleston, South Carolina
Kenneth Ruggiero, PhD
Professor
Medical University of South Carolina
Charleston, SC
Tatiana Davidson, Ph.D.
Associate Professor
Medical University of South Carolina
charleston, South Carolina
Aaron Lesher, M.D.
Pediatric Burn Medical Director
Medical University of South Carolina
Charleston, South Carolina
Steven Kahn, M.D.
Chief of Burn Surgery
Medical University of South Carolina
Charleston, South Carolina
Annually, nearly half a million people in the U.S. receive medical treatment for burn injuries, 40,000 of whom are hospitalized. During the pandemic, there has been a significant increase in more serious (2nd and 3rd degree) burns requiring surgical intervention. Studies show that up to 45% of burn patients develop posttraumatic stress disorder (PTSD) and up to 54% develop depression. Undetected or untreated psychiatric symptoms can complicate recovery, increase length of stay, and cause long-term problems and readmission. Burn centers are ideally suited to provide these services to burn patients on an inpatient and outpatient basis; however, at present, few burn centers in the U.S. have mental health programs to address patients’ needs thereby missing opportunities to improve quality of life, accelerate recovery, and reduce functional impairment and readmission. This presentation will describe the Burn Behavioral Health (BBH) program, an innovative burn center-based multidisciplinary technology-enhanced stepped-care model of delivering mental health services for burn patients. Data were collected as part of clinical care through the BBH program. BBH includes 4 main steps: (1) initial screening, education, and early intervention; (2) symptom self-monitoring and self-help resources; (3) follow-up screening 30 days post-injury; and (4) referrals to best-practice mental health services if needed. Between February 2021 and February 2022, 181 patients were admitted to our burn center and identified as eligible for BBH services. Of these, 159 (91%) were enrolled in BBH and completed initial screening (134 inpatient and 25 outpatient). 56% of patients screened positive for depression/PTSD risk or symptomatology and were offered brief intervention. 53% of survivors received brief intervention, 21% of whom completed more than one session. We reached 83% of patients for the 30-day follow-up, 20% of whom screened positive for depression/PTSD and 33% were connected to mental health services. This study provides preliminary support demonstrating that BBH is capable of reaching and engaging a large proportion of burn patients across the inpatient to outpatient continuum. Psychological recovery is an essential component of a comprehensive multidisciplinary burn program and availability of psychological screening and intervention services is a requirement for the American Burn Association (ABA) verification. BBH shows promise in increasing access and quality of mental health care to address the unique mental health needs of burn survivors.