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.