Feasibility of single question mental health surveillance in chronic disease

Area of Science:

• Pediatric mental health surveillance
• Chronic childhood illness
• Healthcare screening tools

Background:

• Children with chronic illnesses are at increased risk for mental health challenges.
• Effective and efficient screening methods are needed in inpatient settings.
• Current screening tools may be time-consuming for busy clinical environments.

Purpose of the Study:

• To assess the feasibility and acceptability of a single-question mental health screen for carers of chronically ill children.
• To evaluate the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of this question.
• To compare the single question's performance against the Strengths and Difficulties Questionnaire (SDQ).

Main Methods:

• A cross-sectional pilot study was conducted in a tertiary pediatric hospital's Day Medical Unit.
• Caregivers of children aged 2-17 with chronic conditions responded to a single mental health question during admission.
• The Strengths and Difficulties Questionnaire (SDQ) was administered to carers and children (11-17 years) for comparison.

Main Results:

• The single question was feasible and acceptable to nursing staff and carers.
• High specificity (0.98) and PPV (0.87) were observed when 'thriving/coping' were grouped, but sensitivity was low (0.2).
• Sensitivity increased to 0.7 when 'thriving' was compared against all other responses, indicating better detection of struggling children.

Conclusions:

• Single-question mental health surveillance is acceptable to carers and nursing staff in an inpatient pediatric setting.
• The screen demonstrates high specificity in identifying children who are 'struggling' or 'always overwhelmed' compared to the SDQ.
• This brief tool shows promise as an efficient method for initial mental health screening in this population.