Article

OBJECTIVE: To determine whether a positive screen on the Traumatic Brain Injury-4
(TBI-4) can be used to identify veterans who use more inpatient and outpatient
mental health services. DESIGN: Validation cohort. SETTING: Medical center.
PARTICIPANTS: Individuals seeking Veterans Health Administration mental health
services (N=1493). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: One year
of inpatient and outpatient mental health utilization data after the TBI-4 screen
date. RESULTS: In the year postmental health intake, those who answered
positively to any of the 4 TBI-4 screening questions (criterion 1) or question 2
(criterion 2; ever having been knocked out) had significantly more psychiatric
hospitalizations than those who met neither criterion. Those who were positive by
criterion 2 also had significantly fewer outpatient mental health contacts.
CONCLUSIONS: Veterans screening positive for history of traumatic brain injury on
the TBI-4 had more hospital stays in the year postmental health intake. Those who
reported having been knocked out also had fewer outpatient mental health visits.
These findings may suggest an overall relation in this population between greater
needs for mental health care and likelihood of prior injury. For those with a
history of loss of consciousness, the reduced use of outpatient care may reflect
greater problems engaging in treatment or with preventive aspects of the health
care system during non-crisis periods. Using a screener (eg, the TBI-4) could
facilitate identification of veterans who might benefit from targeted and
intensive outpatient interventions to avoid frequent inpatient psychiatric
hospitalization.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS