title: Where to start? Attempting to meet the psychological needs of burned patients.
abstract: The National Burn Care Review Committee [National Burn Care Review Committee. National Burns Care Review. Standards and Strategy for Burn Care; 2001] recommend routine psychosocial screening for all burned in-patients, as well as access to different levels of psychological input. This paper aims to report on: (1) a system which integrates routine clinical practice, psychological screening and a system of data collection to identify level of need; (2) an audit of the range of levels of psychological input required to meet this need. All consecutive admissions (n=72) to a regional burns unit were screened within a week of admission using the Hospital Anxiety and Depression Scale (HADS), the Impact of Event Scale (IES) and a screening tool developed in the unit. Clinical input was provided as required and recorded. Thirty-five percent reported a previous mental health problem. Forty percent fell into 'borderline' or 'caseness' on the HADS. Fifteen percent met a level of clinical 'caseness' on both the intrusions and avoidance subscales of the IES. Sixty-three percent required some level of psychological input during their in-patient stay. Given the high level of need identified and the range of levels of psychological intervention identified, a system of routine screening and a tiered model of psychological care is proposed to best utilise psychological resources.
authors.affiliation: Academic Division of Clinical Psychology, School of Psychological Sciences, University of Manchester, 2nd Floor ERC Building, Wythenshawe Hospital, Manchester M23 9LT, United Kingdom. julie.wisely@manchester.ac.uk
authors.forename: J A
authors.initials: JA
authors.lastname: Wisely
authors.forename: E
authors.initials: E
authors.lastname: Hoyle
authors.forename: N
authors.initials: N
authors.lastname: Tarrier
authors.forename: J
authors.initials: J
authors.lastname: Edwards
mesh_terms: D000328:Adult; D002056:Burns / Q000523:psychology*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D020380:Needs Assessment; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires