Over 40 per cent of major trauma patients suffer from anxiety and depression, an audit carried out by Southampton General Hospital found. The Hospital’s study confirmed that many major trauma victims suffer from psychological as well as physical injuries, with almost a third experiencing psychosocial issues such as relationship or body image concerns. The results highlighted how easily major trauma can affect family dynamics and relationship roles and go on to influence rehabilitation and discharge planning.
Another recent study of patients treated in ICU found that over half reported significant symptoms of anxiety, depression, or PTSD over the following two years and that those with depression were nearly 50 per cent more likely to die in that period than those without.
Alongside impacting personal and familial relationships, a particularly problematic consequence of the psychological impact of major trauma is the impact it has on one’s ability to engage in the rehabilitation they need to recover physically. The commonly seen combination of chronic pain, sleep disturbance, fatigue, and cognitive dysfunction (such as difficulty with concentration and memory), as well as the side effects of medication, make it very difficult for a person to participate effectively in physical rehabilitation. The coexistence of underlying mental illness, such as depression, anxiety, or PTSD, makes this significantly more difficult and risks damaging the patient’s long term recovery process and limiting their final outcome.
Unfortunately, the provision of mental health care continues to fail to match the availability of support for physical injuries. Physical rehabilitation is of course an integral part of the recovery process for major trauma survivors, but to focus on this solely is not enough – we must take a holistic approach to rehabilitation that encompasses mental wellbeing and social community care. Adopting a holistic view of rehabilitation from the outset will result in a more effective treatment for major trauma survivors, and drastically improve long term patient outcomes, with improved quality of life, greater social reintegration, and lower ongoing healthcare costs.
To achieve this truly holistic approach to rehabilitation will require the right attitude and mindset from all parties involved in major trauma and personal injury recovery. From health professionals and insurers, to lawyers, major trauma survivors and their families, psychological rehabilitation must be prioritised by all from the outset. Where insurers have made some noticeable savings during the pandemic, additional contributions to the rehabilitation and recovery of major trauma survivors would be a welcome respite to our overburdened NHS. With greater funding and emphasis behind a holistic approach to rehabilitation, we can vastly improve the lives of thousands of people recovering from major trauma injuries and their families.
The full version of this article was published in Solicitors Journal in March 2021. To access the article click here.
 Chartered Society of Physiotherapy (CSP) ‘Mental Barriers: the hidden effects of trauma’ [internet]. Available at: https://www.csp.org.uk/frontline/article/mental-barriers-hidden-effects-trauma
 Hatch et al. (2018) Anxiety, Depression and Post Traumatic Stress Disorder after critical illness: a UK-wide prospective cohort study. Critical Care. 22:310.