Citation

Kurowski BG, Wade SL, Kirkwood MW, Brown TM, Stancin T, Taylor HG. PM R 2013; 5(12): 1026-1034.

Affiliation

Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH. Electronic address: brad.kurowski@cchmc.org.

Copyright

(Copyright © 2013, American Academy of Physical Medicine and Rehabilitation, Publisher Elsevier Publishing)

DOI

10.1016/j.pmrj.2013.08.589

PMID

23973505

Abstract

OBJECTIVE: To characterize utilization of mental health services and determine the ability of a behavior problem and clinical functioning assessment to predict utilization of such services within the first 6 months after moderate and severe traumatic brain injury (TBI) in a large cohort of adolescents. DESIGN: Multicenter cross-sectional study. SETTING: Outpatient setting of four tertiary pediatric hospitals, two tertiary general medical centers, and one specialized children's hospital. PARTICIPANTS: Adolescents age 12-17 years (N=132), 1 to 6 months after moderate to severe TBI. METHODS: Logistic regression was used to determine the association of mental health service utilization with clinical functioning as assessed by the Child and Adolescent Functional Assessment Scale (CAFAS) and behavior problems assessed by the Child Behavioral Checklist (CBCL). MAIN OUTCOME MEASURE: Mental health service utilization measured by the Service Assessment for Children and Adolescents (SACA). RESULTS: Behavioral or functional impairment occurred in 37 to 56%. Of the total study population, 24.2% reported receiving outpatient mental health services, 8.3% reported receiving school services, and 28.8% reported receiving any type of mental health service. Use of any (school or outpatient) mental health service was associated with borderline to impaired total CAFAS (OR [CI] = 3.50 [1.46, 8.40], p < 0.01) and CBCL total competence (OR [CI] = 5.08 (2.02, 12.76), p < 0.01). CONCLUSIONS: A large proportion of participants had unmet mental health needs. Both the CAFAS and CBCL identified individuals who would likely benefit from mental health services in outpatient or school settings. Future research should focus on methods to ensure early identification by health care providers of adolescents with TBI in need of mental health services.

Language: en