Identifying Children and Adolescents at Elevated Mental Health Risk Before and During COVID-19.
Michael Jellinek, Talia S Benheim, Anamika Dutta and 4 others
PMID 39146230WHAT IT FOUND
Adolescent girls showed the largest increase in mental health risk during the pandemic.
Global risk rose significantly in this group, driven by internalizing and attention symptoms. Screening at once-yearly visits may underestimate risk if conducted in summer.
Key findings
01Adolescent girls showed the largest worsening in global, internalizing, and attention risk from before to during the pandemic.
02Impairments in psychosocial functioning were systematically higher during the school year, a pattern that was already present prior to the pandemic.
03Screening at once-yearly health supervision visits may underestimate some children’s levels of psychosocial impairment if the visit takes place during the summer months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Nearly 90% of data on race, ethnicity, and insurance type were missing, so the study could not analyze differences across these groups or control for changes in sample composition over time. The study used binary sex data from electronic health records and lacked information on self-reported gender identity. The sample came from practices using the CHADIS system, which may not be nationally representative, though the practices varied widely in location and patient characteristics. The study compared groups at different time points rather than following individual children longitudinally, so it cannot determine within-child trajectories of risk.
Declared interests
One author (R. Sturner) and his spouse (B. Howard) developed the CHADIS web tool used in the study. They are also paid employees or consultants to the Center for Promotion of Child Development through Primary Care and Total Child Health, which are associated with CHADIS.
The easy way to misread this
Do not assume that a child screened in summer with a normal PSC-17P score is free of psychosocial risk. The study found that risk is significantly higher during the school year, so summer screening may miss children who are struggling.