History repeats itself: Impact of mental illness on violent reinjury and hospital reencounters among female victims of interpersonal violence

BACKGROUND: Violence-related reinjury impacts both patients and health care systems. Mental illness (MI) is prevalent among violently injured individuals. The relationship between preexistingMI and violent reinjury among women has not been fully characterized. Our objectivewas to determine if risk of hospital reencounter-violent reinjury and all-cause-was associatedwith preexistingMI at time of index injury among female victims of violence. METHODS: All females (15-100 + years) presenting to a level I trauma center with violent injury (2002-2019) surviving to discharge were included (N = 1,056). Exposure was presence of preexisting MI. The primary outcome was hospital reencounters for violent reinjury and all-cause within one year (through 2020). The secondary outcome was the development of a new MI within one year of index injury. Odds of reencounter and development of new MI for those with and without preexistingMIwere comparedwithmultivariable logistic regression, stratified for interaction when appropriate. RESULTS: There were 404 women (38%) with preexisting MI at time of index injury. Approximately 11% of patients with preexisting MI experienced violent reinjury compared to 5% of thosewithout within 1 year (p < 0.001). Specifically, thosewithMI in the absence of concomitant substance use had more than three times the odds of violent reinjury (adjusted Odds Ratio, 3.52 (1.57, 7.93); p = 0.002). Of those with preexisting MI, 64% had at least one reencounter for any reason compared to 46% of those without (p < 0.001). Odds of all-cause reencounter for those with preexistingMI were nearly twice of thosewithout (adjusted Odds Ratio, 1.81 [1.36, 2.42]; p < 0.0001). CONCLUSION: Among female victims of violence, preexisting MI is associated with a significantly increased risk of hospital reencounter and violent reinjury within the first year after index injury. Recognition of this vulnerable population and improved efforts at addressing MI in trauma patients is critical to ongoing prevention efforts to reduce violent reinjury.