Changes Over Time in Outcomes of School-Age Children and Parents Receiving Integrated Mental Health Care in Federally Qualified Health Centers.
Jihye Kim, Megan H Bair-Merritt, Jessica Rosenberg and 5 others
PMID 37566878WHAT IT FOUND
Children in integrated mental health care showed significant improvements in internalizing symptoms and school attendance over 12 months, but parent depression and stress did not change.
Without a control group, these gains cannot be attributed solely to the intervention.
Key findings
01Internalizing symptoms improved significantly by 12 months, while externalizing symptoms did not reach statistical significance.
02School attendance improved significantly, with fewer missed days and fewer school contacts about mental health problems.
03Parental outcomes, including depression, anxiety, and parenting stress, showed no statistically significant changes.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study lacked a comparison group, so improvements cannot be distinguished from natural maturation or regression to the mean. The sample size was small (51 children), which may have limited the ability to detect effects in secondary outcomes. School functioning data relied on parent recall over the past 30 days, which is subject to recall bias. Selection bias is possible, as enrolled families may have been more engaged in care than those who did not enroll. Detailed chart review was precluded by COVID-19 protocols, so analyses reflect intent-to-treat rather than actual service receipt.
Declared interests
Funding was provided by the Health Resources and Services Administration. The authors declared no other conflicts of interest.
The easy way to misread this
Do not interpret the improvements in child symptoms and school attendance as proof that the integrated mental health care model caused them. Without a control group, these changes could reflect natural development, regression to the mean, or other unmeasured factors.