Early Response Concussion Recovery

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1 Early Response Concussion Recovery KRISTA MAILEY, BSW RSW, CONCUSSION RECOVERY CONSULTANT CAREY MINTZ, PH.D., C. PSYCH., PRACTICE IN CLINICAL NEUROPSYCHOLOGY FOR REFERRAL: Contact Krista Mailey at (204) or

2 Background Falls and transport- related incidents (motor vehicle, ATV, bicycle) account for 81% of concussions. Falls are the main cause of concussion-related hospitalization. There were 2,766 concussion-related injuries (Hospital Morbidity Database in Canada) that resulted in hospitalizations in 2010/2011. These do not account for the vast numbers that are not recorded, with uncomplicated concussions who did not attend the hospital. Estimates of the prevalence of self-reported post concussional symptoms at 3 months post-trauma vary between 75-80%. Research has shown that individual s beliefs about the nature and severity of their injury and expectations regarding recovery significantly predict the development of post concussive symptoms. Ultimately, this predicts recovery duration and functional outcome. Research has also demonstrated that a brief early intervention including education about the expected recovery can reduce the incidence of post concussive syndrome, with fewer reported symptoms and symptomatic duration at the 6 month post injury follow up.

3 Purpose The purpose of the service is to: Provide early intervention to individuals ages 13 years and older who have recently suffered from a concussion, and may or may not have been diagnosed by a medical professional. Provide an initial diagnostic assessment (neuropsychological screen) in order to identify any difficulties the client may be experiencing and to provide recommendations regarding treatment. Provide effective and timely treatment with the provision of verbal and written education, reassurance, techniques for reducing symptoms and recommendations for gradual resumption of premorbid activities. Prevent long-term consequences such as post-concussion syndrome (PCS) by identifying clients at risk of PCS and providing them with effective interventions and education early in their recovery. Goal: The service aims to: Identify the client s needs and risk factors as soon as possible. Educate with verbal and written information on concussion and recovery duration. Develop an individualized rehabilitation program that will facilitate a return to activities at home, school and or work.

4 ERCR Service Delivery Flowchart Referral from physician, specialist Self- Referral Referral from third party insurer Self- Referral Criteria Based Acceptance ERCR Criteria Based Declined Review of file and medical documentation. Neuropsychological/ psychological Screen (Min. 3 weeks postinjury) Recovered End Initial intake meeting and risk assessment with client (1 meeting) Written report including needs/risk assessment, neuropsychological test results, current status, return to work/school plan, rehabilitation and referral recommendations, i.e, Full neuropsychological assessment Full psychological assessment Medical consultation Psychological treatment Physiotherapy/other therapy Feedback session with client including neuropsych. test results, education on concussion and techniques for symptom management. (1 session) 1-2 weeks, Follow up with client regarding return to work and school strategies, functional progress update, and client feedback on program efficacy.

5 To be referred, the client: Must And And be 13 years and older, have on-going signs and symptoms such as: mood changes memory problems fatigue difficulty concentrating loss of balance headaches nausea dizziness may have additional risk factors such as: the inability to work or attend school, for more than three weeks second or subsequent concussion or mtbi within 6 months loss of consciousness more than 1 minute. post traumatic amnesia lasting more than 12 hours a pre-existing psychiatric disorder or substance abuse problem Who can refer? A medical practitioner or GP, neurologist, sports medicine physician, third party insurer (i.e. Worker s Compensation Board, private insurance companies) can refer a client to Early Response Concussion Recovery, or by self-referral. You may use the ERCR referral form to send a referral by fax, to (204) , or call Krista Mailey at (204)

6 Service Schedule ERCR offers the following service for all clients: Review of the available initial medical documentation, (i.e. ambulance report, ER and hospital records, GP report and clinical notes). Meet with the client for initial needs/risk assessment and provide general information and reassurance about recovery from concussion. Identifying risk factors that may contribute to symptom prolongation and or delay to work or school. (1 meeting) Concussion Recovery Consultant will consult with Neuropsychologist on each case file. Neuropsychological testing will be arranged for the client at the earliest possible date (minimum 3 weeks post injury). The client will attend a feedback session with the Neuropsychologist and Concussion Recovery Consultant. Written report will be provided to the insurer and GP which will include risk indicators, client s current status and activity level, return to work or school recommendations, neuropsychological test results and treatment and referral recommendations. Concussion Recovery Consultant will follow up with the client on their current symptoms, activity level and return to work/school status.

7 Concussion Recovery Consultant: Krista S. Mailey, BSW, RSW Krista Mailey has over 25 years of experience in implementing and developing individualized rehabilitation programs, and working directly with injured and disabled persons including concussions, Traumatic Brain Injury, developmental disabilities, chronic illness and mental health conditions. Krista has extensive experience as a trainer and educator on Traumatic Brain Injury and concussions. She brings expertise in case management, rehabilitation and return to work or school coordination. Krista worked in a consultant role and resource to case managers on their concussion and TBI claims at Manitoba Public Insurance. She has been a business owner of two Disability Rehabilitation Management companies. Krista earned a bachelor s degree in Social Work from University of Manitoba and is a registered professional with the Manitoba Institute of Registered Social Workers. Krista received specialized training in brain injuries at the G.F. Strong Rehabilitation Centre in Vancouver, British Columbia and achieved an Applied Management Certificate through the Continuing Education Division at University of Manitoba Neuropsychologist: Carey Mintz, Ph.D., C. Psych. Dr. Carey Mintz is a Neuropsychologist in Private Practice. She obtained her doctorate in Clinical Psychology from the University of Manitoba, and completed specialized training in Clinical Neuropsychology and Behavioural Medicine at the Menninger Department of Psychiatry and Behavioural Sciences at the Baylor College of Medicine in Houston, Texas, and Clinical Neuropsychology at the Regents Centre for Learning Disorders at Georgia State University in Atlanta, Georgia. Prior to going into full-time private practice, Dr. Mintz was an Assistant Professor within the Department of Clinical Health Psychology of the Winnipeg Regional Health Authority, where she was first a member and then the chair of the Neuropsychology Service Team. Dr. Mintz has expertise in the neuropsychological assessment of a broad range of issues, including Traumatic Brain Injury, stroke, and neurological disorders such as MS, brain tumours, and neurodegenerative disorders. She also brings expertise in the assessment and treatment of a broad range of psychiatric/psychological concerns including mood disorders, anxiety disorders, and major mental illness, as well as in the psychological treatment of individuals coping with the effects of illness and injury.

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