Suggestions for improving outcomes in the NHS following "mild" traumatic brain injury in adults, a bio-psycho-social approach

Purpose: Mild traumatic brain injury (mTBI) is a common occurrence. For most people recovery is quick and complete. For a minority disability persists. This paper aims to discuss the factors that likely give rise to this on-going disability and discuss the current evidence-based approaches to treatment. Design/methodology/approach: A selective review of the contemporaneous research literature was undertaken. Findings: On-going disability following mTBI is likely to be secondary to a combination of factors, namely subtle organic damage, psychological factors and situational/motivational factors. These factors likely operate to different degrees in different individuals and may vary over time in individual cases. Treatment in the form of a multi-disciplinary assessment, accurate sign-posting to appropriate services and cognitive-behavioural psychotherapy is likely to improve outcomes for some with on-going disability following mTBI. Research limitations/implications: Future research should aim to identify at an early stage post-injury those individuals at risk of developing on-going disability following mTBI and the efficacy of different treatment approaches. Practical implications: Earlier identification of individuals not making the expected rapid recovery from mTBI, followed by appropriate multi-disciplinary assessment and intervention would likely improve outcomes for patients at risk of developing on-going disability following mTBI. Originality/value: This paper is of value to healthcare professionals who encounter individuals reporting on-going symptoms and problems following an apparently mild traumatic brain injury.