Left Behind After Impact: The Hidden Toll of Trauma Recovery in New Zealand

BACKGROUND: Major trauma recovery extends beyond physical healing, with psychological outcomes and patient experiences influencing long-term well-being. This study explored trauma survivors' experiences of follow-up care and Accident Compensation Corporation (ACC) in New Zealand, and how these relate to psychological distress and social support. METHODS: A retrospective cohort study was conducted at Christchurch Hospital using New Zealand Major Trauma Registry data (May 2016-March 2020, Injury Severity Score ≥ 12). In 2020, eligible patients were invited to complete a follow-up survey including DSM-5-aligned screeners for PTSD, anxiety, and depression, questions on follow-up care and ACC, and a validated social support scale. Associations were assessed with chi-square and Mann-Whitney U tests; free-text responses underwent thematic analysis. RESULTS: Of 415 eligible patients, 134 (32.3%) responded. Issues accessing follow-up care were reported by 20 patients (14.9%), and ACC-related challenges by 33 (24.6%). Thematic analysis identified insufficient follow-up, lack of mental health support, communication gaps, and premature return-to-work expectations. Psychological morbidity was strongly associated with reported difficulties: patients screening positive for PTSD, anxiety, or depression were 3-5 times more likely to report problems with follow-up or ACC (all p < 0.001). Lower perceived social support was also significantly associated with increased reported difficulties (p = 0.01-0.03). Injury severity and ICU admission were not associated. CONCLUSION: Mental health symptoms and poor social support were strongly linked to dissatisfaction with trauma follow-up and ACC processes. Routine psychological screening, improved communication, and coordinated support may enhance recovery outcomes in New Zealand's no-fault trauma system.