A new trauma psychology service launched in 2018 by Hamad Medical Corporation’s (HMC) Hamad Trauma Center is providing emotional support to more than 25 patients a week, who are affected by traumatic injuries.

In Qatar and the wider Gulf region, trauma is the leading cause of death and injury in the young adult population.

Every year, the Hamad Trauma Center receives between 2,000 and 2,500 patients, with many of these individuals struggling to cope with the consequences of their traumatic injuries.

Dr Tulika Agarwal, clinical psychologist at the Department of Trauma Surgery says individuals respond to trauma in different ways, experiencing a wide range of physical and emotional reactions.

“A large number of patients we see in the Trauma Center have suffered life-changing injuries as the result of a motor vehicle crash, pedestrian injury, or fall. The immediate concern of our trauma teams is to deliver the medical treatment they require to stabilise their condition physically, but many of these patients also require psychological support to help them come to terms with what has happened and to move on,” said Dr Agarwal.

“Unfortunately, due to the severity of trauma, we see patients whose lives have changed dramatically as a result of their injuries.

This may mean they can no longer use one or more of their arms or legs, or that a limb has had to be amputated. Many patients suffer severe pain due to rib fractures, for example, and will require a complete change in their lifestyle to live with their injury.

"This kind of sudden change can be extremely difficult for the individual to accept, and this is why the role of the trauma psychology service is so important,” said Dr Agarwal.

She explained that patients who have experienced a traumatic injury can be affected by depression or post traumatic stress disorder (PTSD) and may experience intrusive thoughts, avoidance, nightmares, flashbacks, mood swings, and irrational displays of anger which can lead to hyper-vigilance.

By assessing patients admitted to the Trauma Center on a daily basis, and with referrals from trauma physicians, Dr Agarwal is able to identify those patients most likely to need psychological support.

“The sooner I can meet with the patient and offer psychological support, the greater the chance of limiting any adverse emotional and mental impact. For this reason, I try to meet with them as early as possible to discuss their experience and assess their mental state. For some patients, just a few sessions may be all they need to come to terms with their condition. Other patients will require more long-term support, which we can provide in the trauma psychology service outpatient clinic,” noted Dr Agarwal.

She added that the emotional side of a patient’s recovery can also have an influence on their physical recovery.

“If a patient is suffering from depression or PTSD, it can be very difficult for them to find the motivation to fully commit to their physical rehabilitation and this may mean that their recovery journey is slower. If we can get a patient in a positive state of mind, they are far more likely to reach their full potential more quickly,” said Dr Agarwal.

“I see many distressing and unfortunate cases where people’s lives have been devastated. But I also get to see how powerful the human mind is and how inspirational people can be. Many patients show incredible mental strength and positivity in the face of adversity and this is hugely beneficial to their recovery,” she added.

In addition to providing psychological support to trauma patients, Dr Agarwal also offers support to the staff in the Hamad Trauma Center.

“Every day, our trauma staff see the devastating impact of traumatic injuries firsthand, and this can be very emotionally challenging. De-briefing sessions are very beneficial when the incidents have been especially challenging for the team. Our trauma staff is able to come and talk to me one-on-one and intermittently I have sessions with the teams so that they understand the common signs that indicate when they may be suffering emotionally," said Dr Agarwal.

“With excellent intra-team co-ordination and the exceptional support of the trauma leadership, the Trauma Psychology Service has become a valuable part of the system, and has, in turn, made the care of patients with traumatic injuries a truly holistic endeavour."

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