Universal Trauma Screening in an Adult Behavioral Health Setting.

ABSTRACT

PURPOSE/OBJECTIVES: The Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) with Criterion A was universally used in admission screening to pilot a trauma-informed care process for quality improvement. DESCRIPTION OF THE PROJECT All adult inpatient behavioral health patients at a Mid-Atlantic county hospital were screened for trauma exposure on admission. Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition with Criterion A was provided to all adults admitted to a 27-bed inpatient behavioral health unit for 8 weeks. Quantitative descriptive statistics were calculated based on self-report PCL-5 scores; qualitative data were gathered from staff and stakeholders. OUTCOME: During the pilot period, there was a 49.2% response rate. Fifty respondents (53.8%) screened positive for trauma as recorded on the Criterion A portion. Seventeen (18.3%) were negative for trauma self-report, and 26 (30.0%) did not complete this portion. Fifty-six (60.2%) completed screens scored 33 or greater on the PCL-5 portion. Staff found the timing of administration convenient but expressed concern over emotional cost to patient. CONCLUSIONS: Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition with Criterion A served as guidepost for trauma-informed assessment, treatment, and referrals. Future considerations may include timing of presentation to patient, electronic translation of the tool to facilitate interdisciplinary collaboration, and tracking of screening completion.