Preferences of parents for mental health services to suit children with chronic medical conditions
Jemimah Ride
A * , Lachlan Cameron A , Renee Jones A B , Kim Dalziel A , Danielle Wurzel C D E , Kung-Ting Kao F G , Jeremy L. Freeman E H and Harriet Hiscock B I J
A Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Level 4, 207 Bouverie Street, Parkville, Vic., Australia.
B Health Services, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, Vic., Australia.
C Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Vic., Australia.
D Department of Respiratory and Sleep Medicine, The Royal Children’s Hospital Melbourne, 50 Flemington Road, Parkville, Vic., Australia.
E Respiratory Group, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, Vic., Australia.
F Department of Endocrinology and Diabetes, The Royal Children’s Hospital Melbourne, 50 Flemington Road, Parkville, Vic., Australia.
G Diabetes Group, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, Vic., Australia.
H Department of Neurology, The Royal Children’s Hospital Melbourne, 50 Flemington Road, Parkville, Vic., Australia.
I Department of Paediatrics, University of Melbourne, 50 Flemington Road, Parkville, Vic., Australia.
J Health Services Research Unit, The Royal Children’s Hospital Melbourne, 50 Flemington Road, Parkville, Vic., Australia.
Australian Health Review 46(6) 722-730 https://doi.org/10.1071/AH22075
Submitted: 16 March 2022 Accepted: 5 September 2022 Published: 4 October 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.
Abstract
Objectives To identify features of mental health services that affect the uptake of services among parents of children with chronic medical conditions, to inform the design of pathways into mental health care.
Methods A discrete choice experiment in which participants made choices between hypothetical mental health services described in terms of service features: cost, wait time, provider knowledge of chronic medical conditions, recommendations, opening hours, and travel time. Participants were parents of children attending The Royal Children’s Hospital outpatient clinics for the management of a chronic medical condition who completed the online survey between August 2020 and January 2021. The uptake of mental health services with differing features was predicted based on regression models examining the relationship between choice and service features, and accounting for participant characteristics and unobserved heterogeneity.
Results The sample comprised 112 parents, of whom 52% reported unmet needs. The most influential service features were wait times, cost, recommendation from medical specialists, and mental health provider knowledge of chronic medical conditions. Predicted uptake of a realistic service showed inequalities across income, parental education, and single parent status. A service comprising preferred features was predicted to eliminate these inequalities.
Conclusions Reducing cost and wait time for mental health services could reduce unmet need among children with chronic medical conditions. Specific approaches to tackle the high levels of unmet needs in this group include equipping medical specialists to recommend mental health providers and training mental health providers on the impacts of chronic medical conditions on children. Offering preferred services could increase uptake and reduce inequalities in mental health care.
Keywords: child health, delivery of healthcare, health economics, health services research, mental health services.
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