Mental Health Diagnosis and Costs After Unintentional Injuries and Assaults.

Abstract

Unintentional injuries and assaults cause nearly 28 million emergency department visits each year and can incur lasting physical and psychological damage. This study examined whether unintentional injuries and violence increase mental health disorders and spending. In 2025, authors analyzed 2022 U.S. MarketScan employer-sponsored insurance enrollees (N=19.1 million). Enrollees with emergency department visits for unintentional (n=105,389) or assault (n=1,986) injuries were matched to controls (by age, sex as reported in the data source, residence region, health plan type, and comorbidity count). All subjects were observed 6 months before and 12 months after the emergency department visit date. New mental health disorder diagnosis (anxiety, bipolar disorder, major depression, other mood disorders, attention-deficit/hyperactivity disorder, post-traumatic stress disorder, sleep disorders), new psychotropic drug prescription, total injury-attributable medical spending, and mental health-specific medical spending were assessed. Costs were assessed as 2022 U.S. dollars. People with emergency department-treated unintentional injuries were 34%, and those with assault injuries were 98% more likely than controls to have a new mental health diagnosis in the year after the emergency department visit. They were also 50% and 71% more likely, respectively, to have a new psychotropic drug prescription. Excess spending on mental health services and prescriptions during the year after the injury averaged $302 for unintentional injuries and $711 for assaults. Unintentional injuries and assaults render affected individuals more vulnerable to mental health disorders and increase mental healthcare spending. It is critical to ensure efficient access to mental health services and consider mental health costs as a part of the economic burden of injuries and violence.