Maternal mental health and pediatric health care use: A national sample of Medicaid and SCHIP insured children

While research has shown that health care use is associated with mental health status, there is less information on the extent to which a mother's mental health impacts her children's health care use. Preventive pediatric health care promotes healthy development and well being via developmental, behavioral, and psychosocial assessments, as well as immunizations and other preventive services. These may be particularly important for children of mothers with a mental illness as they are at heightened risk of health and mental health problems. Applying the Andersen Behavioral Model of Health Services Use as a framework, this study examined the association between maternal mental health status and pediatric health care use in a nationally representative sample of 17,830 women parenting children ages 0-17 insured through Medicaid or SCHIP. Highlighting a need amenable to intervention, results indicated that mothers with a mental health problem were significantly more likely to experience greater levels of poverty, single parenthood, less education, fewer parenting supports and greater difficulty coping with parenting than mothers without a mental health problem. Still, they tended to access preventive and emergency department care for their children at levels comparable to mothers without a mental health problem, suggesting their resilience as caretakers. Finally, all mothers reported relatively high reliance on emergency care and suboptimal preventive care use for their school age and adolescent children, suggesting that all Medicaid- or SCHIP-insured children could benefit from targeted engagement strategies that link them with consistent and appropriate sources of pediatric health care.