This study investigated the recognition of psychopathology by the surgical team in 56 trauma patients independently evaluated by the authors for current psychiatric diagnosis using research criteria. Thirty-four per cent of patients (N = 19) met criteria for one or more psychiatric disorder, with alcohol abuse/dependence the most frequent diagnosis (N = 16). Examination of medical records showed no mention of psychopathology or related treatment plan for 13 of 19 patients (68%). Three patients' charts had brief comments related to the psychopathologic diagnosis, and three charts documented requested psychiatric consultation. This study demonstrates that substantial treatable psychopathology was undocumented and untreated in a trauma surgery patient population.