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Purpose The burden of injuries is disproportionately concentrated among Black men in the United States. Previous studies suggest that the mental health effects of trauma may vary by the intentionality of the injury (intentional vs. unintentional), yet little is known about this experience among Black men. We explored the emotional responses to traumatic injuries in the context of injury intentionality among Black men in an urban area. Methods We conducted semi-structured, qualitative interviews with 74 Black men who were traumatically injured. The interviews took place three months after discharge from the hospital and they were audiotaped, transcribed, and de-identified. We used systematic thematic analysis to identify themes about post-trauma emotional responses to intentional and unintentional injuries. Results The narratives of intentionally injured men revealed persistent exposure to neighborhood violence and their distrust of others including the people they knew and to whom they felt close. Survivors of unintentional injuries did not express a similar distrust of others. Our findings suggest that survivors of intentional injuries experience loss of social support following their injuries. Conclusions Emotional responses can differ by intentionality of traumatic injury among urban Black men. Intentional injuries may be a marker for chronic exposure to violence and limited social support for recovery. Additional resources should be targeted to survivors of intentional injury who return to disadvantaged communities after medical treatment to decrease risk of re-traumatization and adverse emotional responses.

Dear SirIt was interesting to read the analysis from Pugh et al. on resident perceptions about learning following a formative OSCE examination (Pugh et al. 2017). In particular, we found their emph...

OBJECTIVES: Psychological distress is common in survivors of traumatic injury, yet across United States’ trauma systems, it is rare that standard injury care integrates psychological evaluation and professional mental healthcare. The purpose of this study was to explore help-seeking for psychological symptoms in injured Black men living in Philadelphia. DESIGN: A subset of a cohort of 551 injured Black men admitted to a Trauma Center in Philadelphia participated in qualitative interviews that explored their perceptions of psychological symptoms after injury and the factors that guided their decision to seek professional mental health help. Data from 32 participants were analyzed for narrative and thematic content. RESULTS: Three overarching themes emerged: (1) facilitators of help-seeking, (2) barriers to help-seeking, and (3) factors underlying the decision not to consider professional help. Five participants felt that their injury-related psychological distress was severe enough to merit professional help despite any perceived barriers. Seventeen participants identified systemic and interpersonal obstacles to professional help that prevented them from seeking this kind of care. These included: financial constraints, limited access to mental healthcare services, and fear of the judgments of mental healthcare professionals. Ten participants would not consider professional help; these men perceived a lack of need and sufficiency in their existing social support networks. CONCLUSIONS: Research is needed to inform or identify interventions that diminish the impact of barriers to care, and identify from whom, where, and how professional mental health help might be more effectively offered to injured Black men in recovery environments like Philadelphia.