Over the past few years, more and more attention has been given to the impact that mild traumatic brain injuries (TBI) have on children. One area that has been looked at recently has been what harm is done to the mental health of children who suffer these injuries.
At least 500,000 children visit emergency rooms every year and are diagnosed with concussions. This seems to be on the increase. Between 2001 and 2009, the rates for children being diagnosed with a concussion or mild TBI went up by 57% for kids who were 19 years old or younger. Now researchers are looking at the impact these injuries are having on the mental health needs of these children, according to Reuters Healthandnbsp;and as published on Medscape.
New research shows that more and more children who suffer this kind of injury are receiving increased mental health services. Most of the children already had a diagnosis of some mental health issue or another.
Dr. Nathalia Jimenez and colleagues from the University of Washington in Seattle write that, “Mental health symptoms after mTBI are prominent and often attributed to the TBI. It remains unclear if utilization of post-mTBI mental health care is related to development of new symptoms or previous illness.”
The team at the University of Washington took advantage of the Medicaid Marketscan claims database to analyze and determine how many children who suffered a mild TBI were treated by a mental health professional in the period of time beginning 12 months before they sustained the injury and 12 months afterwards.
They looked at the records for more than 31,000 children. In terms of preexisting mental health diagnoses, they looked at 22,695 who had no such diagnoses and 8,577 who did. For the children with mental health diagnoses, about 44% had been diagnosed with attention-deficit/hyperactivity disorder (ADHD) and 33% had been diagnosed with mood disorders.
This study just reinforces earlier research which has shown that after children suffer mild TBIs, their usage of mental health services does go up. They also added that the majority of children who were receiving increased mental health care who already had been diagnosed with a mental disorder. They noted that at last 86% of the children who received these services had such a diagnoses.
The team noted, “Having a mental health diagnosis pre-mTBI was the most important risk factor for receiving post-mTBI mental health care (odds ratio 7.93, 95% confidence interval 7.40-8.50).”
Dr. Jimenez told Reuters Health by email, “Our study showed that children with prior mental health disorders increased their use of mental health services after injury, which is in agreement with prior clinical studies. However, it is important to keep in mind that the increased use of services, peaked one month after injury and returned to baseline after two months. This underscores the importance of close follow up of these patients during the first months after injury.”
There were disparities between different ethnicities in terms of who received this kind of care. Latino children were the least likely to get any mental health help after sustaining such an injury.
Dr. Jimenez said, “Based on this new finding, we recommend clinicians caring for minority patients, specially those with language and cultural barriers, to educate parents about possible mental and behavioral problems after mild TBI. Also we recommend to maintain a closer follow up of these children, to diagnose new mental or behavioral disorders that might be missed by parents or that parents might be reluctant to address.”
There are still a lot of things researchers do not know about the impact that suffering a traumatic brain injury as a child has on their development. What is known is how pervasive the problem of mild TBI is. The Centers for Disease Control and Prevention (CDC) reports that TBI Is the leading cause of disability and death in children. Children who are ages zero through four and 15 to 19 have the highest risk for sustaining this type of injury.
While it is still unclear what is causing the children and adolescents who suffer from a mild TBI to need more mental health counseling after their injury than they needed before, one thing is clear, much more research on the subject is needed.
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