Community-Based Early Intervention with Trauma Survivors

The number of individuals affected by frequently occurring traumatic events such as accidents and assaults, as well as large-scale traumas such as war and disaster, calls for systematic, comprehensive community-based responses to manage mental health consequences of such exposure. This chapter reviews several key components of such a comprehensive response; these components can be initiated immediately after a trauma occurs. Communities should develop capacity to identify and engage those at risk for continuing problems; provide phased support to include immediate assistance, brief counseling after the immediate period, and treatment for trauma-related problems; and provide opportunities for participation in trauma-related community activities. Two domains of posttrauma care, hospital-based acute care of injury and assault survivors and disaster mental health, are reviewed to illustrate ways of developing some of these components. Key challenges include engagement of survivors with early interventions, training of providers and effective implementation of interventions, program monitoring and evaluation, and integration of Internet and mobile interventions into community-based service delivery. In the future, there remains significant opportunity for service innovation and improvement of interventions, a need to develop and implement population-based intervention approaches, and an imperative to increase research into early posttrauma interventions in community settings.