Trauma & ICU Psychiatric Care
Critical illness is a medical event. It is also often a psychological one. The psychiatric needs of ICU survivors are real and treatable.
What critical illness leaves behind
Surviving an ICU stay is a medical outcome. It is also, frequently, a psychiatric event. Delirium during admission, fragmented and frightening memories, PTSD after discharge, and cognitive changes that nobody warned the family about are common and under-recognised.
The same applies to the staff. People who work in critical care accumulate exposure that does not resolve on its own, in a culture where saying so is read as not coping.
This writing comes from years in a Level I trauma center neuro ICU, on both sides of that.
Post-intensive care syndrome
A recognised cluster follows critical illness: cognitive impairment, psychiatric symptoms, and physical weakness persisting long after discharge. Patients are rarely told to expect it. They go home assuming recovery is a matter of regaining strength, and then find their memory is unreliable and their sleep is broken by things they cannot quite recall.
ICU delirium during admission is a strong predictor of what follows. The fragmented, frequently frightening memories that remain afterwards are not imagination, and they respond to treatment.
And the people who work there
Critical care staff accumulate exposure at a rate other specialties do not, inside a culture where naming it reads as not coping. The result is a workforce that recognises psychiatric injury in patients quickly and in itself almost never.
ICU delirium: what happens after the acute illness ends
The confusion clears, but something remains. That something is treatable.
When substance use and trauma intersect in the ICU
The ICU experience is traumatic. For someone with a substance-use history, it is more complicated than that.
Supporting ICU survivors' return to work
Returning to work after critical illness is not the same as returning after vacation.
PTSD after critical illness: why the ICU can be a traumatic event
Being unable to breathe is terrifying. That terror is not irrational.