Mental Health Disparities Following Violent Injury: A Prospective Comparison of Survivors of Violent and Nonviolent Mechanisms of Injury.

Abstract

Aim and background: Violence is a global crisis causing deleterious effects on survivors and the health of communities. Yet, there is limited prospective research examining the mental health of violence-related injury survivors. Longitudinally assessing differences in mental health outcomes following violence-related and nonviolent injuries can inform what comprehensive approaches to recovery are needed to reduce disparities following violence.

Materials and methods: Participants (N = 245) presenting to a midwestern level 1 trauma center following injury completed measures of posttraumatic stress disorder [PTSD symptom checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)], depression, anxiety, stress, [Depression, Anxiety, and Stress Scale (DASS-21)] posttrauma and 6 months later.

Results: Analyses of variance revealed that violence-related injury patients experienced chronic or worsening symptoms of PTSD, depression, anxiety, and stress levels, whereas nonviolently injured patients had less severe symptoms that diminished over time.

Conclusion: Compared with nonviolent injury patients, patients with violence-related injuries have poorer mental health, regardless of injury severity. Further, this disparity appears to grow by 6 months, which has significant implications regarding individual and community health. Screening and effective treatment of mental health issues among violence survivors is necessary to address comprehensive needs and reduce the overall impact of violence.

Clinical significance: Violence-related injury survivors are at risk for psychopathology, which impacts recovery, quality of life and limits, and reengagement with society. Tertiary prevention efforts must account for the role of mental health when supporting survivors.