Inclusion Criteria:  patients 18 and older under the care of the UF Orthopedic Trauma Division admitted to UF Health for trauma resulting in one or more extremity or pelvic fractures requiring surgery will be screened.  Exclusion Criteria:  patients with Traumatic Brain Injury or a past medical history of bipolar or other mental health conditions on current medical management will be excluded patients unlikely to follow up (live in at a distance from Gainesville, incarcerated etc.) will also be excluded.