Behavioral Predictors of Outpatient Mental Health Service Utilization Within 6 Months After Traumatic Brain Injury in Adolescents

Overview

Journal PM R

Publisher Wiley

Specialties Emergency Medicine
Rehabilitation Medicine

Date 2013 Aug 27

PMID 23973505

Citations 6

Authors

Brad G Kurowski

Shari L Wade

Michael W Kirkwood

Tanya M Brown

Terry Stancin

H Gerry Taylor

Affiliations

Soon will be listed here.

Abstract

Objectives: 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 in a large cohort of adolescents.

Design: Multicenter cross-sectional study.

Setting: Outpatient setting of 4 tertiary pediatric hospitals, 2 tertiary general medical centers, and 1 specialized children's hospital.

Participants: Adolescents age 12-17 years (n = 132), 1-6 months after moderate-to-severe traumatic brain injury.

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 and behavior problems assessed by the Child Behavioral Checklist.

Main Outcome Measurement: Mental health service utilization measured by the Service Assessment for Children and Adolescents.

Results: Behavioral or functional impairment occurred in 37%-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 Child and Adolescent Functional Assessment Scale (odds ratio 3.50 [95% confidence interval, 1.46-8.40]; P < .01) and the Child Behavioral Checklist Total Competence (odds ratio 5.08 [95% confidence interval, 2.02-12.76]; P < .01).

Conclusions: A large proportion of participants had unmet mental health needs. Both the Child and Adolescent Functional Assessment Scale and the Child Behavioral Checklist 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 traumatic brain injury in need of mental health services.

Citing Articles

Mood Disorders in Young People With Acquired Brain Injury: An Integrated Model.

Roberts H, Ford T, Karl A, Reynolds S, Limond J, Adlam A Front Hum Neurosci. 2022; 16:835897.

PMID: 35754774 PMC: 9218558. DOI: 10.3389/fnhum.2022.835897.

Bidirectional effects of behavior problems and parenting behaviors following adolescent brain injury.

Moscato E, Peugh J, Taylor H, Stancin T, Kirkwood M, Wade S Rehabil Psychol. 2021; 66(3):273-285.

PMID: 34472926 PMC: 8630644. DOI: 10.1037/rep0000380.

Behavior Problems Following Childhood TBI: The Role of Sex, Age, and Time Since Injury.

Wade S, Kaizar E, Narad M, Zang H, Kurowski B, Miley A J Head Trauma Rehabil. 2020; 35(5):E393-E404.

PMID: 32108717 PMC: 7483173. DOI: 10.1097/HTR.0000000000000567.

Use of Mental Health Services by Adolescents After Traumatic Brain Injury: A Secondary Analysis of a Randomized Controlled Trial.

Huebner A, Cassedy A, Brown T, Taylor H, Stancin T, Kirkwood M PM R. 2017; 10(5):462-471.

PMID: 29097272 PMC: 5930129. DOI: 10.1016/j.pmrj.2017.10.004.

Behavioral Clinical Trials in Moderate to Severe Pediatric Traumatic Brain Injury: Challenges, Potential Solutions, and Lessons Learned.

Wade S, Kurowski B J Head Trauma Rehabil. 2017; 32(6):433-437.

PMID: 28520673 PMC: 5668153. DOI: 10.1097/HTR.0000000000000323.

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