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Major traumatic injury survivors at an increased risk of mental health diagnoses, suicide

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People who experience major injuries requiring hospital admission, such as car crashes and falls, are at increased risk of being admitted to hospital for mental health disorders, found a study by researchers at ICES and Queen’s University. As well, they are at much higher risk of suicide than people without such injuries.

"Major trauma was associated with a 40 per cent increased rate of hospital admission for one or more mental health diagnoses," writes Dr. Christopher Evans, Department of Emergency Medicine, Queen's University, with coauthors. "The most common mental health diagnoses were alcohol abuse, other drug abuse disorders and major depressive disorders."

There is little evidence on the link between major injury and later mental health issues. This large study, published in the CMAJ is based on more than 19,000 patients in Ontario, and contributes to the literature on this important topic. Most participants who had experienced major trauma were male (70.7 per cent), lived in urban areas (82.6 per cent) and had accidental (89 per cent) rather than intentional injuries.

Male sex, low socioeconomic status, rural residence, accidental injuries and surgery for these injuries were associated with higher admissions for mental health issues. Researchers found that children and youth under 18 years of age had the largest increase in admissions for one or more mental health issues after injury. Suicide is also higher in people with major physical injury, with 70 suicides per 100,000 patients per year compared to 11.5 suicides per 100,000 patients in the general population.

"Patients who suffer major injuries are at significant risk of admissions to hospital with mental health diagnoses in the years after their injury and of having high suicide rates during this period," write the authors.

The authors urge that mental health supports should be offered to all trauma victims, with special attention to high-risk patients, including children and youth.

“Mental health outcomes following major trauma in Ontario: a population-based analysis,” was published today in CMAJ.

Author block: Evans CCD, DeWit Y, Seitz D, Mason S, Nathens A, Hall S.

ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario.

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