Screening for Traumatic Brain Injury During Mental Health Evaluations

Abstract

Traumatic brain injuries (TBIs) are a major cause of mortality and long-term functional impairment (Gould, Ponsford, Johnston, & Schonberger, 2011; Whelan-Goodinson, Ponsford, Johnston, & Grant, 2009) and are associated with new-onset or worsening of many psychiatric disorders (Gould et al., 2011; Juengst, Whyte, & Skidmore, 2014; Masel & DeWitt, 2010; Whelan-Goodinson et al., 2009) including depression, anxiety, and post-traumatic stress (PTSD). Affected patients may also experience personality changes and problems with aggressive behavior, which can negatively influence personal relationships, ability to work and overall quality of life. This screening can help identify a past TBI, which may influence current mental health status and level of psychosocial function as well as leading to more patient referrals for further evaluation such as neuropsychological testing. Current psychiatric mental health nurse practitioner (PMHNP) and other mental health provider TBI screening practices during mental health evaluations are widely varied with many screening questions being limited only to asking about history of concussions, loss of consciousness or motor vehicle accidents resulting in head injury. This information though important may be insufficient in determining TBI history and symptoms. This project used a pretest posttest design and an educational webinar to provide an overview of TBI and to introduce a brief brain injury screening tool which could be used by providers during mental health evaluations. Overall the educational offering was positively received with the all participants (n = 11, 100%) reporting improved knowledge of TBI and intent to use the screening tool in clinical practice.