J Trauma Acute Care Surg. 2026 Mar 18. doi: 10.1097/TA.0000000000004955. Online ahead of print.
ABSTRACT
BACKGROUND: After an accidental injury, 20% to 40% of youth experience mental health challenges. Although the American College of Surgeons requires universal behavioral health screening in pediatric trauma centers, most lack formal processes. This initiative aimed to address this by integrating a pediatric psychologist into a multidisciplinary trauma follow-up clinic for holistic postdischarge care.
METHODS: Over the course of 1 year at a pediatric trauma center, a psychologist joined a weekly outpatient clinic. After medical review by advanced practice providers, a warm hand-off was made to the psychologist. The intervention involved universal psychoeducation on trauma responses, coping skills instruction, and administration of validated screening tools (ASC-3, PHQ-2) for youth aged 7 and older. Services were billed using Health & Behavior codes linked to injury diagnosis.
RESULTS: In 1 year, 503 follow-up appointments occurred. The pediatric psychologist met with 157 (31%) patients and families. While 48 youths screened positive, clinical consultation resulted in 42 referrals for mental health evaluation. Integration proved feasible, with visits averaging 20 minutes and causing minimal disruption to clinic flow. Only nine families declined screening, and anecdotal feedback was overwhelmingly positive.
CONCLUSIONS: Integrating a pediatric psychologist into a busy surgical follow-up clinic is a feasible and effective model for fulfilling the ACS mandate for behavioral health screening. This collaborative approach ensures that both the physical and emotional recovery of injured youth are addressed, providing a replicable framework for other trauma centers aiming to deliver holistic care. (J Trauma Acute Care Surg. 2026;00:00-00. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved.).
LEVEL OF EVIDENCE: Therapeutic/Care Management; Level IV.
PMID:41849538 | DOI:10.1097/TA.0000000000004955