Increased behavioral health needs and continued psychosocial stress among children with medical complexity and their families during the COVID‐19 pandemic

Abstract

Objective Children with medical complexity (CMC) and their caregivers are at increased risk for multiple psychosocial stressors that can impact child and family well‐being and health outcomes. During the COVID‐19 pandemic, when access to supports diminished, psychosocial screening and integrated behavioral health (IBH) services in the primary care setting were crucial in identifying and addressing the unique needs of this population Methods Universal screening to identify psychosocial needs was implemented in a primary care clinic for CMC that includes IBH services. Data on the prevalence of psychosocial screening and IBH services for young children and their caregivers before and during the COVID‐19 pandemic were evaluated Results Psychosocial screening levels remained stable during the pandemic. Psychosocial needs were identified for 36% of screeners prior to the COVID‐19 pandemic and 33% during the COVID‐19 pandemic. The need for IBH services increased during the COVID‐19 time period resulting in a significant increase in IBH services Conclusions For CMC and their caregivers, psychosocial needs identified through psychosocial screening remained high during the pandemic, demonstrating the importance of screening for this population. The need for IBH services during the COVID‐19 pandemic increased, underscoring the value and demand for these services particularly during an unprecedented time.

COVID-19 in pediatric lung transplant recipients: Clinical course and outcome

“…Importantly, many families of pediatric LTX recipients have been hesitant to reengage in social interaction with peers, regular school attendance and other higher-risk activities due to their childrens’ immunosuppressed state and failure to produce measurable antibody titers post-vaccination. Data suggest that social isolation, particularly absence from in-person schooling, may negatively impact psycho-social health, normal development and academic success 22 , 23 , 24 , 25 , 26 , 27 . The results of our study suggest that the risk of severe COVID-19 in children and adolescents post-LTX without CLAD is low, and this should be considered when creating recommendations for these patients and in conversations with parents and caregivers.…”

Caregiver stress and social determinants of health in key populations: immigrant parents, parents of children with medical complexity, and adolescent parents

“…The COVID-19 pandemic has exacerbated the stress of caregiving for all parents; caregivers of CMC are no exception. One study looking at psychosocial stress and positive SDOH screening rates among families of CMC prior to the pandemic and during the first ten months of the COVID-19 pandemic found consistent rates of positive SDOH screening, but significantly increased need for integrated behavioral health within their clinic [66 ▪▪ ]. Though not focused specifically on CMC, studies looking at caregivers of children with neurodevelopmental disabilities (such as autism spectrum disorder) and children with physical disabilities (such as cerebral palsy) found a correlation between the disruption in medical, educational and therapeutic services for their children and self-reported caregiver psychological stress [67 ▪▪ ,68 ▪ ].…”

Counseling Families with Children with Medical Complexity

“…Financial burdens became exacerbated with the uncertainty of job securities and out-of-pocket costs increased. Social isolation, caregiver mood symptoms, and food insecurity increased during the pandemic in a pediatric family sample (Von Schulz et al, 2022).…”

“…Relying on a trained health professional to enter the home to provide required daily care can be expensive and, depending on the area, this type of assistance can be difficult or impossible to find. Data suggest the COVID-19 pandemic exacerbated already existing financial strains on families with children with complex care needs (Von Schulz et al, 2021).…”

“…It is well documented that families with children with complex health needs face overwhelming amounts of starting with the initial diagnosis, continuing with unpredictable health outcomes with intermittent health crises, financial concerns, and ongoing interactions with medical professionals (Thompson et al, 2016). The mental health burden for children with medical complexity and their families has amplified through the COVID-19 pandemic (Mitchell, 2021; Von Schulz et al, 2022). Many families lost their ability to meet home nursing hours, faced equipment and supply challenges, and lost their critical social network during extended isolation and quarantine periods (Mitchell, 2021).…”