Mental health screenings -- for anxiety, for example -- is routinely recommended by various pediatric societies. Now, a study from Mount Sinai questions the wisdom of such guidelines. Findings from a large-scale screening effort in a pediatric food allergy clinic, made by researchers at the Icahn School of Medicine at Mount Sinai and led by Eyal Shemesh, MD, were first published online in The Journal of Pediatrics.
"Children who live with food allergies go through a unique struggle in life -- one where they may feel stigmatized, and this could have an effect on their mental health," said Dr. Shemesh, Associate Professor of Pediatrics and Psychiatry and Chief of the Division of Behavioral and Developmental Pediatrics at the Icahn School of Medicine at Mount Sinai. "We've shown that within a highly-specialized program that ensures support for mental health needs, screening for mental health problems such as anxiety, bullying, and reduced quality of life does not result in a better rate of successful referrals for evaluation and treatment. The unexpected finding from this study is that it is probably better to refocus our efforts towards making sure these children have access to behavioral health services when they need them, rather than spend some of those resources on screening."
The data collected by Dr. Shemesh and his team were culled from a review of more than 3,000 patient encounters as part of the EMPOWER (Enhancing, Managing, and PrOmoting WEll-being and Resiliency) Program within the Jaffe Food Allergy Institute at Mount Sinai, making it the largest controlled study of the effect of mental health screenings of pediatric patients seen in specialty care clinics. EMPOWER provides free mental health consultations for children with food allergies and is unique to Mount Sinai: through the study, Dr. Shemesh and his research team hoped to determine whether such screening necessarily resulted in an increased rate of consultations.
Of the more than 3,000 patient encounters during the study period, approximately half were screened and half were not. There was no difference in the rate of successful (completed) mental health evaluations in the screened vs. the non-screened cohort, leading researchers to state that screenings did not lead to an enhanced rate of receipt of follow-up mental health services, even though those were offered for free. In their study conclusion, Dr. Shemesh and his team advocates that available resources may be better spent ensuring the availability of mental health care rather than focusing on screening. Those results are relevant to children with food allergy as well as to the provision of care in other pediatric care settings.
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