One in five people suffers depression after being injured. It’s a psychological effect of trauma that can influence a person’s physical recovery, ability to return to work and relationships.
Yet many hospitals don’t ever address trauma patients’ mental health, Therese Richmond told nurses and nursing students in Spokane this week.
“If we’re focused on saving your life and getting you out the door, we’re not doing our jobs,” she said.
Richmond has spent most of her career in trauma care and trauma research. She’s the associate dean for research and innovation at the University of Pennsylvania School of Nursing, and co-founded a research center at the university focusing on injury science. She was invited to Spokane by the Washington State University College of Nursing as the 2018 Thelma L. Cleveland Visiting Scholar, an annual event honoring the college’s longest-serving dean. Later in the day she talked to undergraduate and graduate students at the college.
Joyce Griffin-Sobel, dean of the WSU College of Nursing, introduced Richmond at the breakfast event, which also served to launch a year-long celebration of the college’s 50th anniversary.
Griffin-Sobel recounted the college’s history of innovation, and said its focus in the near future “will be on our most distinctive element: interprofessional innovation, across campuses, colleges, disciplines and in education, practice, research and service.”
“Our patients need all of us – every profession, every teacher, every researcher,” Griffin-Sobel said. “Unless we work together, we are working in conflict with, or duplicating the work of others and it is the patient who suffers.”
Richmond said injury, whether caused by a car wreck, fall, shooting or stabbing, tends to divide lives into before and after the event.
She realized that first as a young critical-care nurse in Washington DC in the 1970s. She was part of a team that saved a young man’s life after he was shot in the abdomen, but he returned later, telling her, “You saved my life, but I’m not healed.”
Richmond’s research found people talking of their depression long after they’d left the hospital in terms like, “Emotionally, it has done a number on me,” or families saying the person had lost “emotional stability.”
She led the development of a quick, eight-question survey that can be administered in the hospital to help predict which patients may develop depression or PTSD later – the first of its kind in the U.S. for adults. Testing showed it was highly accurate, and that it could be used to identify which patients might need follow-up calls or referrals to mental-health services.
Richmond has spent decades encouraging trauma surgeons and other health care professionals to pay more attention to the psychological effects of injury.
As she wrote in a commentary for The Journal of Trauma in 2005, “We are remiss if we do not address acute psychological responses with the same steely resolve that we address airway, breathing, and circulation. No longer can psychological assessment be viewed as a ‘nice add-on.’ It must be integrated into the very essence of trauma care if we are to improve the outcomes of survivors of serious injury.”
–Story by Addy Hatch
View more photos:
More photos from the Cleveland Visiting Scholar breakfast and address are on Flickr at WSU Health Sciences Spokane.