Mental Health Care in Pediatric Rehabilitation Hospitals: A Biopsychosocial, Collaborative, and Agency-based Service Integration Approach

ABSTRACT

Background: Canadian hospitals are not currently prepared to meet the psychosocial needs of children with disabilities as services are rooted in a biomedical care model.

Objective: To describe a practical and holistic framework for pediatric rehabilitation hospitals to meet the health care needs of children and their families.

Method: An environmental scan was conducted of best practice guidelines, policy documents, and models of integrated mental health care. Recommendations from clinical guidelines and national strategy documents were incorporated to develop a service integration approach.

Results: An agency-based approach was used to develop a two-phase biopsychosocial framework. In framework Phase I, reactive care is provided to mental health concerns. In Phase II, there is a shift to proactive care and mental health wellbeing.

Conclusions: Emphasis is placed on capacity building of clinical staff into best practices for mental health care. Implementation needs and consideration for uptake of the framework are also discussed.

KEYWORDS:

• Pediatric rehabilitation
• mental health
• biopsychosocial
• health care
• interdisciplinary

Acknowledgments

We thank Renee-Marie Ragguett for her assistance with the initial literature review. We also acknowledge the Think Tank at Holland Bloorview Kids Rehabilitation Hospital which comprised 25 members, including five family leaders. This body developed foundational work for the hospital’s Child and Youth Mental Health Initiative culminating in a definition, vision, and scope for mental health care at the hospital and five key objectives (identifying a core team of experts, identification of screening tools, increasing staff competency in mental health, advocating for mental health needs of children and youth with disabilities, and to creating partnerships to bridge service gaps).

Declaration of Conflicting Interests

The author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.