Underdiagnosing and Nontreatment of Posttraumatic Stress Disorder in Community Mental Health: A Case Study

Research indicates that trauma is extremely prevalent among populations seeking community-based services. However, underdiagnosis and nontreatment of trauma-related disorders is widespread. This study explored how one urban community mental health center (CMHC), serving a severely mentally ill (SMI) population, assessed, diagnosed, and treated reported trauma histories. Results indicate that of the 72 consumers in this sample who reported trauma histories (51%), only 2 were diagnosed with posttraumatic stress disorder (PTSD). Instead, those with a reported trauma history were likely to be diagnosed with affective disorders and were almost seven times as likely to be recommended therapy as were those without a trauma history. However, even those recommended therapy were not likely to receive it. Findings indicate significant barriers to PTSD diagnoses and the receipt of therapy services.