In addition to previous research for causes of crashes, national and international science has focused increasingly on crash outcomes during the last decade. This research usually includes the economic costs of crashes and, if people were injured, the nature and outcome of their injuries. Until now, there has been little focus on humanitarian costs like grief and suffering after a crash. Those cannot only be seen in victims of crashes but also in relatives, witnesses and first-aiders. Studies show that after a road crash a significant number of people suffer from psychiatric symptoms. Even though the structures for the treatment of physical harm after a crash are well known in Germany, supply and structures for the treatment of psychological consequences of road crashes are not studied yet. A primary objective of this study was to determine and systemize the existing range of health care services for people who suffer from psychological consequences of road crashes. For this purpose a nationwide investigation identified facilities, which potentially take care of people with mental problems which occur after a road crash. Furthermore, an online survey and telephone interviews with members of these facilities were carried out to analyze the logistic structure of health care services and to investigate the need for optimization in this field. Finally, results were discussed at a workshop for experts to develop precise interventions to improve the range of supply for people who suffer from psychological consequences of road crashes. In the nationwide investigation have been 2,657 facilities identified which potentially take care of people who suffer from psychological consequences of road crashes. All of these facilities have been invited to participate in an online survey. Basic data (n = 155) indicates that there is a broad range of facilities with different professional backgrounds taking care of people who suffer psychological consequences of road crashes. At the same time there seem to be few specialized offers of supply of health care services for the target group. The second part of the survey (n = 110), which focused particularly on difficulties and improvement opportunities, shows clearly that there is need for optimization in this area: The quality of the existing structures of health care services were rated almost bad to moderate by the majority of the participants. For the target audience existing support is hard to find which could lead to a delay in the beginning of adequate treatments. Additionally, a lack of networking communication between involved facilities was identified as problematic, as well as a high workload resulting from bureaucracy instead of support for the patients. Main objective of the interviews (n =17) was to gather more information concerning the involved facilities and the structure of the current situation of suppliers of health care in this matter. Additionally, possible interventions to improve the structure of care for people who suffer from psychological consequences of road crashes were discussed. The interview data confirmed the results of the online survey. Existing support for people with psychological consequences of road crashes was rated insufficient, while a demand for this support was rated high. Amongst other things difficulties in regard to networking between involved institutions, a difficulty for the target audience to be able to find suppliers as well as a lack of awareness for psychological consequences of road crashes were stated. To improve the traceability of existing suppliers, the development of a register of relevant facilities (“Versorgungsatlas”) and an information sheet were recommended by the experts. Focus of the interdisciplinary workshop was to develop interventions to improve the traceability of supply for people who suffer from psychological consequences of road crashes. Main focus was to develop a standard of requirements for a planned “Versorgungsatlas” respectively the information sheet. Details regarding content, quality standards, publication and distribution of instruments were compiled. Additionally, challenges in supporting people with psychological consequences of road crashes were discussed (e.g.: awareness raising of the involved, diagnostics, networking of the involved facilities, procurement of therapy, quality management, assumption of costs). Best practice and suggestions for solutions were presented. Results of the study clearly point out that there is need for optimization in regard to the structure of care for people with psychological consequences of road crashes in Germany. Especially the improvement of traceability of existing supply was identified as a highly important matter. Despite existing limitations of the online survey (e.g. small sample, self-selection of participants) central findings were confirmed by experts in interviews and during the workshop. Recommendation was to continue the efforts to improve structures of care for people who suffer psychological consequences of road crashes. Therefore, a group of members of different facilities established the workgroup “AG Versorgungsatlas” to enhance and implement a “Versorgungsatlas” and information sheet after the workshop. (Author/publisher)
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