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Mental healthcare for children with chronic conditions: a qualitative study
  1. Renee Jones1,
  2. Harriet Hiscock1,2,
  3. Danielle Wurzel3,4,
  4. Kung-Ting Kao5,6,
  5. Jeremy L Freeman7,8,
  6. Jemimah Ride1,9
  1. 1Health Services, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
  2. 2Health Services Research Unit, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  3. 3Department of Respiratory and Sleep Medicine, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
  4. 4Health, Allergy and Lung Health Unit, The University of Melbourne School of Population and Global Health, Parkville, Victoria, Australia
  5. 5Department of Endocrinology and Diabetes, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  6. 6Diabetes Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
  7. 7Department of Neurology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  8. 8Neurosciences Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
  9. 9Health Economics Unit, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
  1. Correspondence to Renee Jones, Health Services, Murdoch Childrens Research Institute, Parkville, VIC 3052, Australia; renee.jones{at}mcri.edu.au

Abstract

Objective To explore parent perspectives on accessing mental healthcare for children with a chronic physical health condition.

Design Qualitative research using semistructured interviews and Framework Analysis. Rankings were used to select attributes for a Discrete Choice Experiment (DCE).

Setting Four specialty outpatient clinics (diabetes, epilepsy, bronchiectasis unrelated to cystic fibrosis and epidermolysis bullosa) at an Australian tertiary paediatric hospital.

Participants Eighteen parents of children with a chronical physical health condition.

Results Most parents identified the child’s general practitioner and/or hospital team as an initial pathway to seek help if they were worried about their child’s mental health. Parents see mental healthcare as part of care for the whole child and want the outpatient clinics to proactively discuss child and family mental health, as well as refer to appropriate services as needed. The hospital being a familiar, child-friendly environment was identified as a key reason the hospital might be a desired place to access mental healthcare, as previous research has found. Six attributes of mental health services were identified as important and will be included in an upcoming DCE: travel time, cost, wait time, available hours, knowledge of physical health condition, and recommendation.

Conclusions This study highlights the opportunity presented in specialist outpatient clinics to address the often unmet mental healthcare needs of children with chronic physical health conditions. Parents identified practical ways for outpatient clinics to better facilitate access to mental healthcare. These will be further explored through a quantitative study of parent preferences.

  • health services research
  • psychology
  • qualitative research

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information. All data relevant to the study are included in the article and supplemental materials.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information. All data relevant to the study are included in the article and supplemental materials.

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Footnotes

  • Contributors All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing or revision of the manuscript. RJ collected the data, carried out analysis, drafted the initial manuscript, and reviewed and revised the manuscript. JR and HH conceived of the presented idea. JR collected the data, carried out analysis, and reviewed and revised the manuscript. HH, K-TK, JLF and DW verified the analytical methods and supervised the findings and interpretation of results of this work. All authors discussed the results and contributed to the final manuscript.

  • Funding This work was supported by the Murdoch Children’s Research Institute Population Health Theme Funding 2019. Professor Hiscock is supported by NHMRC Practitioner Fellowship Award 1136222. The Victorian Government’s Operational Infrastructure Support Program support research at the Murdoch Children’s Research Institute.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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