Mental Health Conditions Among Hospitalized Children
Statement of Problem
Over the past decade, the prevalence of mental health diagnoses has been rising among children seeking short-term medical care for a serious condition. Mental health conditions, such as anxiety, ADHD and depression, affect at least one in 10 U.S. children hospitalized for a medical condition or surgical procedure.
Despite increasing recognition that mental health conditions are common among hospitalized children, hospitals report challenges ensuring adequate mental health resources for their patients. In addition, families and clinical teams aren’t always on the same page about caring for mental health conditions, which can lead to further complications in diagnosing and treating these conditions. Understanding the need for mental health resources and ensuring those resources are available for hospitalized children is critical to improving physical and mental health outcomes and the value of pediatric hospital care.
Dr. Stephanie Doupnik is working to better understand the relationship between hospitalization and mental health conditions in children. Over the past few years, she has built a research portfolio that provides a comprehensive picture of the many ways in which mental health conditions affect health care delivery, utilization, costs and outcomes for children, including by putting children at higher risk of the following:
- Medical Complications During Hospitalization: One study examined the influence of mental health conditions on hospital outcomes among children hospitalized for pneumonia and found that mood or anxiety disorders were associated with more medical complications and longer hospital stays.
- Readmissions: Children with mental health conditions were more likely to be readmitted to the hospital within 30 days of discharge after a medical hospitalization or surgical procedure compared to children without mental health conditions.
- Health Care Utilization and Costs: Another study showed that hospitalized children with comorbid mental health conditions had much longer hospital stays, which resulted in higher costs for the hospitals and health systems.
- Clinical Team and Family Communication: One study found that hospital staff and families may not be on the same page regarding mental health concerns and diagnoses in children. This may lead to missed opportunities to identify and provide treatments for children with mental illness.
Hospitals are testing innovative models for ensuring that children with mental health conditions and their families receive the evidence-based treatments and psychosocial support. Efforts include changes to physician training, integrating medical and psychosocial care, and programs designed to support parents. Ensuring the long-term success of care models that integrate behavioral health care into acute hospital care will require systems to monitor whether behavioral health services improve patient outcomes, for example by reducing the length of their hospital stay or the need for subsequent repeat hospitalizations, or by improving their functioning after they leave the hospital. Future work to investigate cost-effective payment models will also enhance the uptake of behavioral health integration within inpatient settings.
We will continue to build evidence for policies, programs and practices to improve patients’ outcomes by making mental health services available to children and adolescents in hospital settings.
The Children's Hospital of Philadelphia, PolicyLab. Mental Health Conditions Among Hospitalized Children [Online]. Available at: http://www.policylab.chop.edu [Accessed: plug in date accessed here].