Development of psychological services for facial injury patients East London NHS Foundation Trust

This project was run at the Royal London Hospital and involved developing psychological services to meet the needs of patients following facial trauma, improving access to these services and reducing psychological morbidity following acute trauma.

Almost 40% of patients with facial trauma suffer from post-traumatic stress disorder, depression, anxiety, or alcohol or substance misuse. But most facial trauma patients do not receive mental health assessment or treatment, and maxillofacial teams do not often have direct access to psychological services.

To address these issues, this project by East London NHS Foundation Trust involved a clinical psychologist and research assistant joining the maxillofacial trauma team for one year. All facial injury outpatients completed a psychological screening questionnaire and were given information about coping after facial injury. The clinical psychologist met or phoned all patients whose responses to the questionnaire indicated psychological distress. They were either given further self-help information, signposted to mental health services or offered immediate psychological treatment. The medical team were also trained to better recognise and respond to psychological distress.

The project has demonstrated the feasibility of offering collaborative psychological care within a busy oral and maxillofacial trauma clinic: over 600 facial injury outpatients were screened for psychological difficulties. Positive feedback was given by patients, family members and the medical team.

Challenges encountered during the project included sourcing clinical space within the oral and maxillofacial trauma clinic for confidential psychological consultations, and that the psychological needs of patients often extended further than originally planned; for example risk assessment and liaison with family members who were traumatised. 

Supporting dissemination

This project was given further support through a Spreading Improvement grant to help disseminate learning and maximise the impact of the approach across the health service.

Funding will be used to disseminate information, knowledge and skills that are needed to introduce evidence-based practice through local primary care pathways for Medically Unexplained Symptoms (MUS) patients. This will be done through a variety of activities including; the development of educational materials, training of staff to deliver novel body-orientated interventions for MUS sufferers, and the development of an information and networking platform for clinical staff and service users.

Contact details

For further information about the project, please email Sarah Heke at East London NHS Foundation Trust.