Objective:
There are known disparities in access to and utilization of pediatric health care and mental health care. Unmet health-related social needs, particularly food insecurity and housing instability, have previously been associated with poorer health and mental health outcomes as well as reduced utilization of preventive care. The relation between health-related social needs and pediatric mental health care utilization, however, has been largely unexplored.
Method:
Using a cross-sectional design with retrospective data extraction through a large, urban medical center’s clinical data warehouse, this study investigated whether parent-reported unmet health-related social needs were associated with differences in the relationship between parent-reported child psychiatric symptoms and pediatric mental health care utilization. Additionally, the association between pediatric mental health care utilization and visiting an on-site food pantry, offered to address food insecurity, was assessed.
Results:
Consistent with the hypotheses, parent report of higher child psychiatric symptoms was associated with more pediatric mental health care utilization (rate ratio [RR] = 1.17, p < .001), and as parents reported more unmet health-related social needs, this relationship weakened (B = −.015, p < .001). Although the use of the on-site food pantry had no effect on the relationship between reported child symptoms and pediatric mental health care utilization, the use of the food pantry did independently correspond to an increased rate of mental health care visits (RR = 2.25, p = .002).
Conclusions:
These findings suggest that screening for and addressing unmet health-related social needs may be an important part of the effort to reduce pediatric mental health service disparities.
Implications for Impact Statement
This study found that as families’ health-related social needs, such as food insecurity and unstable housing, increased in number, children and adolescents with more psychiatric symptoms accessed less mental health care. Furthermore, the findings indicated that pediatric mental health care utilization at an urban medical center rose along with visits to an on-site food pantry. Identifying and addressing families’ health-related social needs may help to reduce disparities in who receives needed mental health care services. Within clinical practice, this can be achieved through universal health-related social needs screening and the provision of relevant referrals and resources.
