title: Survivors of violence-related facial injury: psychiatric needs and barriers to mental health care.
abstract: OBJECTIVE
  This study examined mental health needs, receptivity to psychosocial aftercare, and barriers to care among survivors of violence-related facial injuries.
  
  
  METHODS
  Face-to-face interviews were conducted with 25 consecutively treated individuals at a hospital-based specialty outpatient clinic one month after a violence-related facial injury. To participate in the study, patients had to screen positive for an alcohol use disorder (AUD), major depression or posttraumatic stress disorder (PTSD). Participants were questioned about receptivity to an aftercare program and perceived barriers to care.
  
  
  RESULTS
  Of those screened for study eligibility (n=62), a substantial proportion met probable criteria for AUD (31%), PTSD (34%) and major depression (35%). Among those completing the core interview (n=25), 80% met probable criteria for two or more psychiatric disorders. The majority (84%) expressed interest in psychosocial aftercare. However, barriers such as cost, insufficient information about counseling and obtaining services, transportation and preferences for self-reliance were commonly endorsed.
  
  
  CONCLUSIONS
  Survivors of violence-related facial injuries have substantial mental health needs and appear receptive to psychosocial aftercare. However, significant treatment barriers must be addressed. Findings underscore the value of a collaborative care model for treating violence-related facial trauma patients seeking care in specialty outpatient oral and maxillofacial clinics.
authors.affiliation: RAND Corporation, PO BOX 2138, Santa Monica, CA 90407, USA. ewong@rand.org
authors.forename: Eunice C
authors.initials: EC
authors.lastname: Wong
authors.forename: Grant N
authors.initials: GN
authors.lastname: Marshall
authors.forename: Vivek
authors.initials: V
authors.lastname: Shetty
authors.forename: Annie
authors.initials: A
authors.lastname: Zhou
authors.forename: Howard
authors.initials: H
authors.lastname: Belzberg
authors.forename: Dennis-Duke R
authors.initials: DD
authors.lastname: Yamashita
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D005151:Facial Injuries / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000628:therapy*; D017741:Survivors / Q000523:psychology*; D014754:Violence