For acutely injured patients multiple physical, financial, social, medical, and legal post-trauma concerns exist that may limit the ability to focus exclusively on the psychological sequelae of the trauma. Injured patients treated within trauma care systems are at high risk for developing post-traumatic stress disorder (PTSD). Acute care mental health services research programs aim to address the mental health needs of populations of injured patients presenting for treatment in the acute care medical setting. Recent investigation suggests that emergency department heart rate alone has only modest specificity and sensitivity for the prediction of chronic PTSD symptoms. Mental health professionals have been observed to converge on the scene of mass disasters. Rather than immediately preparing for early intervention targeting post-traumatic stress, newly arriving mental health professionals could be assigned as care managers to injured patients triaged through acute care settings.