141st APHA Annual Meeting

In This section

284946
Association between having a medical home and mental health service utilization among u.s. children with a mental health condition, 2007

Tuesday, November 5, 2013

Izumi Chihara, MD, MPH , School of Public Health, University of Illinois at Chicago, Chicago, IL
Rani Gallardo, BS , School of Public Health, University of Illinois at Chicago, Chicago, IL
Kristin M. Rankin, PhD , School of Public Health, University of Illinois at Chicago, Chicago, IL
Background: Mental health problems of U.S. children are prevalent (11%) but often overlooked. Using data from 2007 National Survey of Children's Health, this study examined the association between having a medical home and mental health service utilization. Methods: Analyses were restricted to children ages 2-17 with one of seven mental health conditions (weighted N=9,479, representing 7,372,814 U.S. children). Seven mental health conditions were ADD or ADHD; depression; anxiety problems; behavior or conduct problems; Autism, Asperger's Disorder, pervasive developmental disorder, or other ASDs; any developmental delay that affects the ability to learn; and Tourette syndrome. Several demographic, child, parental, family, and community factors were considered for inclusion in the final logistic regression model. All analyses accounted for the complex design of the survey. Results: Overall, 40% of children had a medical home. Only 46% received mental health services in the past 12 months. Because there was significant interaction between medical home and having a diagnosis of ADD/ADHD (p<.05), the interaction term was included in the final model. Among children with ADD/ADHD, having a medical home was associated with lower odds of receiving mental health services: AOR 0.51 [95% CI 0.37-0.69]. On the other hand, among children without ADD/ADHD, having a medical home was not associated with mental health services use: AOR 0.99 [0.72-1.38]. Conclusions: Our results indicate that there may be a lack of integration between primary care and mental health services, and a lack of availability of mental health services beyond the primary care setting.

Learning Areas:
Epidemiology
Public health or related research

Learning Objectives:
Assess the relationship between having a medical home and mental health service utilization among U.S. children with a mental health condition.

Keywords: Child and Adolescent Mental Health, Health Care Utilization

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a medical degree, and I am currently a PhD student in Maternal and Child Health Epidemiology at University of Illinois at Chicago. I have worked on several federally funded projects at University of Illinois at Chicago.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.