Barriers and facilitators to engagement in a stepped-care mental health service among violently injured patients and their caregivers.

This qualitative study aimed to identify service needs and barriers and facilitators to treatment among violently injured patients and their caregivers (e.g., parent, partner) to improve access to and quality of care. Participants included 14 violently injured patients admitted to a Level 1 trauma center (M_age = 28 years, 92.8% Black, 92.8% male) and eight of their caregivers (M_age = 44 years, 100.0% Black, 100.0% female). Semistructured interviews were audio-recorded, transcribed, and deidentified. A team of three coders analyzed the data using thematic analysis. Results indicated that desired in-hospital services included social and emotional support, financial support, and support for caregivers. Desired postdischarge services included financial support and services to promote physical and emotional recovery. Patients often mentioned needing mental health services for their caregivers, whereas caregivers frequently discussed the need for financial assistance and services to support patients' physical recovery after discharge. Common facilitators for engaging in mental health treatment included support from hospital staff, family, and friends in navigating mental health service systems. Reported barriers to engaging in mental health services were a lack of readiness and limited resources. The findings highlight the critical need to integrate comprehensive care programs within trauma centers to support violently injured patients and their caregivers, reduce barriers to postinjury mental health care, and enhance access to mental health treatment.