Use of Mental Health Services by Adolescents After Traumatic Brain Injury: A Secondary Analysis of a Randomized Controlled Trial.
Andrea R S Huebner, Amy Cassedy, Tanya M Brown and 4 others
PMID 29097272WHAT IT FOUND
After moderate to severe TBI, mental health service use stayed low and stable.
The online family problem-solving program with counselor support did not change use compared with online TBI resources, and less than half of impaired adolescents received services.
Key findings
01Mental health service use was low and stable: 30% of participants at baseline, 31% at 6 months, 28% at 12 months, and 22% at 18 months.
02Impaired participants were about 3 times more likely to receive services than nonimpaired participants, but no more than half of impaired participants received services at any time.
03Service use did not differ by treatment group or time from injury, and gender, race/ethnicity, and socioeconomic status did not predict service use.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The sample was mostly white (80.3%) and had a higher median income than the US median, so results may not apply to more diverse or lower-income families. Participants had to speak English at home, live within a 3-hour drive of a study center, and have high-speed Internet access. Eight percent of potential participants were excluded for the English language requirement. Service use was based on parent report, and school service reports were not corroborated with school records. Behavioral and executive function ratings were also parent report; teacher ratings were not collected. The study did not collect mental health service use before injury, so it is hard to know how much use was new after TBI. It did not ask why services were not used, so barriers are not directly measured. It focused on behavioral and emotional services, not school services for cognitive or learning problems. Attrition was not random: parents who dropped out tended to be younger, have lower incomes, be single parents, and their adolescents had higher baseline behavior problems.
Declared interests
No conflicts of interest were declared. The supplied article metadata lists NIH extramural research support, but the text does not give a specific funding statement.
The easy way to misread this
Do not conclude that the online family problem-solving program failed to help adolescents after TBI. This secondary analysis examined mental health service use, not clinical outcomes such as behavior or functioning, and service use did not differ between the problem-solving and resource groups.