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A Psychiatry Service for Parents of Children With Medical Complexity
Kayla Esser1,2, Neda Askari3, Nichelle Benny Gerard1
1Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
Insights
Parents of children with medical complexity often experience mental health challenges, with most receiving new psychiatric diagnoses like depression and anxiety. Integrated care models and virtual services can improve access to mental health support for these caregivers.
Area of Science:
- Psychiatry
- Pediatric Complex Care
- Mental Health Services Research
Background:
- Children with medical complexity (CMC) require extensive caregiver support due to chronic conditions and technology dependence.
- Parental caregivers of CMC frequently experience suboptimal mental health.
- The psychiatric profiles of parents of CMC are not well-understood.
Purpose of the Study:
- To describe the clinical and demographic characteristics of parents of CMC receiving care from an integrated psychiatry service.
- To identify common psychiatric diagnoses and treatment recommendations for this population.
Main Methods:
- A descriptive case series utilizing retrospective electronic medical record review (2020-2023).
- Inclusion of 57 parents of CMC referred to a novel psychiatry service integrated with a pediatric complex care program.
- All psychiatric assessments and treatments were delivered via virtual consultations.
Main Results:
- A high proportion of parents (79%) received new psychiatric diagnoses.
- The most prevalent diagnoses included depressive disorders (67%), anxiety disorders (65%), and trauma- and stressor-related disorders (56%).
- Recommended treatments were primarily psychotherapy (95%) and pharmacotherapy (75%). The sample comprised 84% females with a mean age of 42 years.
Conclusions:
- A significant number of treatable psychiatric illnesses were identified in parents of CMC.
- Integrated pediatric complex care and psychiatry services, enhanced by virtual delivery, can improve access to mental health care for this vulnerable group.
- Further research is needed on treatment adherence and efficacy in this caregiver population.
Background And Objectives:
Children with medical complexity are caregiver dependent because of complex, chronic health conditions; functional limitations; technology dependence; and high health care use. Their parental caregivers have suboptimal mental health, yet little is known about the psychiatric profiles of this group. We aimed to describe the clinical and demographic characteristics of parents of children with medical complexity seen by an integrated psychiatry service.
Methods:
This is a descriptive case series using retrospective medical record review of electronic medical records from 2020 to 2023. We developed a novel psychiatry service in partnership with a pediatric complex care program for diagnostic assessment and treatment of parental caregivers of children with medical complexity in Toronto, Ontario. We included all parents of children with medical complexity who were seen by the psychiatry service for assessment and treatment of suspected mental illness (n = 57).
Results:
Most parents received a new diagnosis (79%); the most common diagnoses were depressive disorders (67%), anxiety disorders (65%), and trauma- and stressor-related disorders (56%). Common treatment recommendations included psychotherapy (95%) and medication (75%). The sample was 84% female with a mean age of 42 years (SD 6 years). All consultations occurred virtually.
Conclusions:
We identified a high number of treatable psychiatric illnesses in the referred parents. Partnerships between pediatric complex care teams and psychiatry services and using virtual care may help with timely and accessible mental health care for this at-risk population. Future research could investigate adherence to and efficacy of treatment recommendations for this caregiver population.
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