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Physical Injuries Raise Mental Health Risks

Children hospitalized for an unintentional injury had on average a 63 percent increase in mental health diagnoses and a 155 percent increase in medications prescribed to treat a mental illness, a study from the Center for Injury Research and Policy, the Center for Pediatric Trauma Research, and the Center for Suicide Prevention and Research at Nationwide Children’s Hospital found.

Children under 4 years old with burns and children of all ages with head injuries were at greatest risk for new mental health diagnoses after injury. The rate increases were most notable for stress-related conditions including adjustment disorders, disruptive behavior disorders, eating disorders, learning disorders and sleep disorders.

The study, published in The Journal of Pediatrics, looked at children ages 0 to 18 years who were hospitalized for unintentional injuries at Nationwide Children’s from June 2005 through May 2015. All children in this study were enrolled in the hospital’s managed-Medicaid program, which allowed evaluation of baseline mental health.

“When we look back at medical records, it’s clear that there are often serious mental health concerns after children go home.” – Julie Leonard, MD

“We expect children to show a certain amount of stress and discomfort as a result of spending time in the hospital for an injury,” says Julie Leonard, MD, associate director of the Center for Pediatric Trauma Research, principal investigator in the Center for Injury Research and Policy, and senior author of this study. “When we look back at medical records, it’s clear that there are often serious mental health concerns after children go home. We, as health care providers, need to do a better job assessing children for mental health needs, identifying high risk children, and referring them to mental health providers before sending them home.”

The researchers believe this study is the first showing the impact of injuries on children’s mental health.

Behavioral health providers suggest that these findings mean parents also need to be vigilant after their child sustains an injury. “If your child is behaving differently – for example, not sleeping well, experiencing changes in behavior or mood, or struggling to focus in school – talk to your pediatrician or seek help from a behavioral health specialist,” says Sarah VerLee, PhD, psychologist at Nationwide Children’s.

CITATION:
Bushroe KM, Hade EM, McCarthy TA, Bridge JA, Leonard JC. Mental Health after Unintentional Injury in a Pediatric Managed-Medicaid Population. The Journal of Pediatrics. 2018 Aug;199:29-34.e16.

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