Citation

Olson-Madden JH, Homaifar BY, Hostetter T, Matarazzo BB, Huggins J, Forster JE, Schneider AL, Nagamoto HT, Corrigan JD, Brenner LA. Arch. Phys. Med. Rehabil. 2014; 95(5): 925-929.

Affiliation

VA VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Denver, CO; University of Colorado (UCD), Anschutz Medical Center Department of Psychiatry, Aurora, CO; UCD SOM Departments of Physical Medicine and Rehabilitation and Neurology, Aurora, CO. Electronic address: Lisa.Brenner@va.gov.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.apmr.2014.01.008

PMID

24480334

Abstract

OBJECTIVE: To determine whether a positive screen on the Traumatic Brain Injury-4 (TBI-4) can identify Veterans who utilize more inpatient and outpatient mental health services. Two criteria to identify a positive screen were evaluated. DESIGN: Validation cohort. SETTING: Veterans Affairs Medical Center. PARTICIPANTS: Individual seeking Veterans Health Administration mental health services (N=1,493). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: One year of inpatient and outpatient mental health utilization data following the TBI-4 screen date. RESULTS: In the year post-mental health intake, those who answered positively to any of the four TBI-4 screening questions (Criterion 1) or Question 2 (Criterion 2; ever being "knocked out") had significantly more psychiatric hospitalizations compared to 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 TBI on the TBI-4 had more hospital stays in the year post-mental health intake. Those who reported having been "knocked out", also had fewer outpatient mental health visits. These findings may suggest an overall relationship 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 healthcare system, when they are not in crisis. Using a screener such as the TBI-4 could facilitate identification of Veterans who might benefit from targeted and intensive outpatient interventions to avoid frequent inpatient psychiatric hospitalization.

Language: en