Study investigates family physicians’ experiences managing mental health complications following concussion

By Leah Snidman. This article was initially published in our Concussion Update newsletter; please consider subscribing.

A research article in Concussion studied the “barriers and facilitators” that family physicians face when helping patients manage mental health complications following a mild traumatic brain injury (mTBI). Despite clinical practice guidelines for mTBI requiring proactive screenings and initiation of mental health treatments, the article claims that family physicians are not consistently following these guidelines. The physicians in this study identified more “barriers” than “facilitators” when describing their ability to help their patients manage mental health complications after an mTBI. Some of the “barriers” stated were the limited knowledge of resources and limited referral options for mental health specialty care. 

Eleven family physicians participated in this qualitative study and were interviewed about their experiences with helping patients manage mTBIs and mental health complications. The study found common themes throughout the interviews that highlighted why family physicians are not consistent in following mTBI management guidelines. Barriers included the physicians not having a clear role in mental health treatment and not being aware of the tools to help guide mTBI-related mental health treatment within their practice.

Family physicians were found to rely on general mental health screening tools and attempted to refer patients to specialized mental health physicians, often with difficulty. In addition, physicians found that mental health complications after mTBIs were difficult to detect and treat. Despite the barriers identified by family physicians, they perceived themselves to have an essential role in mTBI treatment. They also believed that managing post-mTBI complications facilitated better patient outcomes. 

Based on the results, the researchers suggest several steps to enhance treatment. They recommend that mTBI guidelines (including mental health post-mTBI) should be more “adaptable, usable, and easily communicated” through “active knowledge transfer strategies, such as tailored recommendations, decision support tools, or interactive education sessions.” Further, family physicians need to have options to refer patients to mental health specialists when unsure about treatment without encountering long waitlists or prohibitive costs for patients. Limitations to the study include the small number of study participants and the issue that family physicians who agreed to participate likely had an above-average interest in post-mTBI mental health.