Comprehensive System of Post-Accident Care in the Czech Republic - A Qualitative Study
Authors: Červinka David , Sulíková Barbora , Vondrackova Lucie , Adamovska Eva 
Published: June 2023

Background and objectiveEvery road traffic accident has the potential to be a traumatic event and may result in significant disruption to the psychological integrity of the people involved. The impact of a road traffic accident can adversely affect the quality of mental and physical health and subsequently interfere with many areas of one's social life.This qualitative study aims to map post-accident psychological care in the Czech Republic in its entirety, from short-term psychological first aid (PPP) at the scene of a traffic accident to long-term psychotherapeutic care. The focus is on identifying weaknesses and strengths in the system of care provided, with an emphasis on describing the connection between each level of care. MethodsData collection was based on semi-structured interviews and focus groups. The survey sample consisted of experts whose practice involves providing some form of psychological care to road accident participants. The study involved 41 interviews with 39 experts and 3 focus groups with a total of 18 experts. The audio and audiovisual recordings were then transcribed and analysed using a thematic analysis method. Results Based on interviews with experts, a shift forward in the overall concern for the psychological state of those involved in traffic accidents was observed in comparison to the past. The Integrated Rescue System plays a significant role in the field of post-accident care. In particular, systematic educational activities are carried out within these units, which increase the motivation and quality of the psychological care provided by the responding emergency units. The establishment of intervention teams within hospital facilities was identified as an essential step in terms of short-term psychological care for physically injured individuals.The limitations of the current approach to short-term care are seen by many experts in the fact that intervention at the scene of a traffic accident is mainly provided to victims of serious traffic accidents who show obvious signs of traumatisation. The assessment of the situation with regard to contacting a crisis interventionist is based on objective criteria of the severity of the traffic accident, which are most often assessed by the police patrol or the intervention commander. In this respect, there is therefore a risk that psychological care will not be available, for example, to those involved in less serious accidents, but who are at a comparable risk of psychological traumatisation. The individuals who caused the accident are also a neglected group. A significant drawback of the current post-accident care system is the availability of follow-up care. The centres are unevenly spread over the country, and in the case of psychological care covered by health insurance companies, clients face long waiting times or financial difficulties in the case of private care. The experts interviewed all concurred that some potential clients are not captured by the aftercare system also because there is a general lack of public education about mental health, the potential impact of a traumatic event, and the options for aftercare. In some regions, post-accident care is tied to a specific individual who promotes or provides it. With their departure from the centre, there is then an insufficient continuation of activities. ConclusionsThe qualitative analysis of the collected data revealed the functional aspects of the current system of post-accident care and at the same time pointed out its shortcomings. The activities of the integrated rescue system providing short-term care directly at the accident scenes were described as highly functional. The limitations of the system are the difficulty in accessing follow-up care, the continuity and insufficient cooperation of the entities providing short-term and long-term care. In the current form of post-accident care, the problem at the most fundamental level is the absence of a systemically based and well communicated concept of post-accident care that would ensure widely accessible care for all those in need. There is no simple and well-connected system in terms of continuity and follow-up care.