Background <p>Children (aged 4 to 11) and youth (aged 12 to 17) with chronic health conditions (CHC; e.g., asthma, diabetes) are at an increased risk of developing mental health (MH) problems relative to those without CHC. We examined how patterns of visits received for CHC influenced receipt of MH care.</p> Methods <p>Using secondary analysis of health administrative data and the 2014 Ontario Child Health Study, we documented the types of MH services contacts (specialized and general health professionals) children had. Hierarchical logistic regressions were used to test the contribution of previous physical healthcare use in predicting MH services. We controlled for factors known to influence MH service access, including previous MH services. The moderating effect of parents who perceive a need for MH help and having a family physician (FP) was also examined.</p> Results <p>For every one-visit increase in FP and specialist visits for a CHC, the odds of children having contact with specialized services increased 1.06 and 1.18 times, respectively. The odds of children whose parents recognized a need for MH help were 16.58 times more likely to report specialized services and 5.49 times more likely to report general services, than children whose parents did not perceive a need. The odds of children with an FP using general MH services (e.g., walk-in clinic, pediatrician, emergency department) were reduced by 81%, compared to those without an FP.</p> Conclusion <p>While previous physical healthcare use increases the odds of MH service contact, perceived need for treatment and having a FP were stronger predictors. Children with a FP who receive MH services in the primary care setting seem to have less general MH services. These findings underscore the importance of patient-centred care approaches that prioritize patients’ and families’ perspectives and the pivotal role of FP in MH treatment.</p>

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Accessing providers for co-occurring health and mental health disorders for children and youth in Ontario: an analysis of linked survey and administrative health data

  • Grace Golden,
  • Li Wang,
  • Graham J. Reid

摘要

Background

Children (aged 4 to 11) and youth (aged 12 to 17) with chronic health conditions (CHC; e.g., asthma, diabetes) are at an increased risk of developing mental health (MH) problems relative to those without CHC. We examined how patterns of visits received for CHC influenced receipt of MH care.

Methods

Using secondary analysis of health administrative data and the 2014 Ontario Child Health Study, we documented the types of MH services contacts (specialized and general health professionals) children had. Hierarchical logistic regressions were used to test the contribution of previous physical healthcare use in predicting MH services. We controlled for factors known to influence MH service access, including previous MH services. The moderating effect of parents who perceive a need for MH help and having a family physician (FP) was also examined.

Results

For every one-visit increase in FP and specialist visits for a CHC, the odds of children having contact with specialized services increased 1.06 and 1.18 times, respectively. The odds of children whose parents recognized a need for MH help were 16.58 times more likely to report specialized services and 5.49 times more likely to report general services, than children whose parents did not perceive a need. The odds of children with an FP using general MH services (e.g., walk-in clinic, pediatrician, emergency department) were reduced by 81%, compared to those without an FP.

Conclusion

While previous physical healthcare use increases the odds of MH service contact, perceived need for treatment and having a FP were stronger predictors. Children with a FP who receive MH services in the primary care setting seem to have less general MH services. These findings underscore the importance of patient-centred care approaches that prioritize patients’ and families’ perspectives and the pivotal role of FP in MH treatment.