Grant: Project Grant

People who sustain a concussion (also known as a mild traumatic brain injury) often develop mental health problems such as depression and anxiety. Mental health problems can make concussion symptoms worse and magnify difficulties with daily activities. Best practice guidelines recommend that family doctors routinely screen for mental health problems after concussion and if present, start treatment or refer to a mental health specialist. Unfortunately, this does not happen in the majority of cases. Depression and anxiety are frequently missed, and treatment is delayed. Drawing on theories of behaviour change, we have developed a strategy for supporting family doctors to implement mental health screening and early treatment after concussion. Patients will learn about the study when they attend a local Emergency Department. After leaving the Emergency Department, they will complete standardized questionnaires that screen for depression and anxiety. The screening test results will be shared with their family doctor, along with advice from best practice guidelines about which mental health treatments are most likely to work. A portion of the patients in the study will also receive written education about the significance of mental health problems after concussion and a decision-aid to help them discuss treatment options with their family doctor. For comparison, some doctors and patients will not receive any screening test results or specific recommendations. The study findings should help us understand how to ensure that the 250,000 Canadians a year who get a concussion will be checked for mental health problems, and directed to an effective treatment without delay.