Despite the known prevalence of mental health issues that emerge during adolescence, nearly half lack a medical home, which could provide them with the appropriate treatment, says a new study from UCSF’s Department of Pediatrics.
According to experts, approximately 20 percent of adolescents report symptoms of mental health problems, and half of lifetime cases of mental health disorders begin showing symptoms by age 14. The medical home provides comprehensive team-based care led by a primary care physician who coordinates all elements of a patient’s care, and is recommended by the American Academy of Pediatrics. In fact, a higher percentage of adolescents have mental health conditions rather than physical conditions, and if it is addressed early, it can lessen the impact, researchers say.
This study is timely as expansion of medical home models are being implemented through the Patient Project and ACA.
In the medical home model, the pediatric care team works together to help a patient and family coordinate, and understand specialty care, educational services, out-of-home care, family support, and other public and private community services that are important for the overall health of the child and family.
UCSF researchers conducted the first study ever to comprehensively examine medical homes for adolescents by reviewing the rates of medical home attainment from the 2007 National Survey of Childrens’ Health (NSCH), a national survey of 91,642 parents, including roughly 45,000 who had children aged 10 to 17.
The researchers then analyzed the past-year medical home rates, whether they varied by age, and whether or not the medical home status was related to an adolescents’ mental health status. They also looked at whether the adolescents were given referrals when necessary.
The researchers found that 46 percent of adolescents lacked a past-year medical home, with lower rates for lower-income, minority and uninsured youth. Adolescents with depression, anxiety, ADHD, learning disabilities, developmental delays are autism diagnoses all had lower medical home rates than those without mental health conditions.
The study also found that medical home rates for Hispanic (33 percent) and black (42 percent) adolescents were significantly lower than rates for white (64 percent) adolescents; and adolescents from non-English speaking households were less likely to have a medical home, receive family-centered care and referrals when necessary.
The study, “Medical home for adolescents: low attainment rates for those with mental health problems and other vulnerable groups,” was published in the March-April issue of Academic Pediatrics.
The study provides an important national baseline for the proportion of adolescents receiving care in a medical home, and can be used to measure progress. The next phase of research will involve analyzing data from the recently released 2011 NSCH which will provide an initial evaluation of changes in medical home status following initiation of the ACA.
Source: UC San Francisco, April 19, 2013:
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