Barriers and facilitators to the management of mental health complications after mild traumatic brain injury

Background: Clinical practice guidelines for mild traumatic brain injury (mTBI) management call on family physicians to proactively screen and initiate treatment for mental health complications, but evidence suggests that this does not happen consistently. The authors aimed to identify physician-perceived barriers and facilitators to early management of mental health complications following mTBI. Methods & results: Semi-structured interviews based on the Theoretical Domains Framework (TDF) were conducted with 11 family physicians. Interview transcripts were analyzed using directed content analysis. Factors influencing management of mental health post-mTBI were identified along five TDF domains. Conclusion: Family physicians could benefit from accessible and easily implemented resources to manage post-mTBI mental health conditions, having a better defined role in this process, and formalization of referrals to mental health specialists.

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Systematic review protocol for facilitators and barriers to integrating health services for traumatic brain injury and mental health or addictions

BMJ Open ◽

10.1136/bmjopen-2018-027534 ◽

2019 ◽

Vol 9 (7) ◽

pp. e027534 ◽

Cited By ~ 2

Author(s):

Vincy Chan ◽

Danielle Toccalino ◽

Angela Colantonio

Keyword(s):

Mental Health ◽

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Health Services ◽

Healthcare Access ◽

Barriers And Facilitators ◽

Cochrane Central Register ◽

Registration Number ◽

Scientific Meetings

IntroductionIn the most populous province of Canada, one in five adults and one in six students report a lifetime history of traumatic brain injury (TBI). These individuals were also more likely to report elevated psychological distress and use illicit substances compared with those without TBI. The need for integrated health services has been recognised globally, yet efforts to develop more comprehensive and effective care for TBI and mental health and/or addictions (MHA) continue to be challenged by the siloing of the two systems. This protocol is for a systematic review that describes the current types of integrated care for TBI and MHA and identifies the barriers and facilitators to integrating healthcare for these populations.Methods and analysisThis review will systematically search MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Sociological Abstracts, and Dissertations & Theses Global. References of eligible articles will also be searched for additional relevant studies. The search strategy will include the use of text words and subject headings relevant to the concepts ‘TBI,’ ‘substance abuse, gambling, or mental health,’ ‘integrated healthcare,’ ‘barriers and facilitators,’ and ‘healthcare access.’ Two reviewers will independently screen all articles based on predetermined inclusion and exclusion criteria and perform quality assessment on eligible studies. A narrative synthesis will be conducted using the data abstracted by the two reviewers.Ethics and disseminationFindings from the systematic review will be published in peer-reviewed journals, presented at scientific meetings, and summarised for key stakeholders in the field of TBI and/or MHA. This protocol will form a systematic review that holds the potential to impact policy and planning in the development of integrated person-centred care for TBI and MHA and addresses a recognised gap in TBI care.Trial registration numberCRD42018108343

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