715 - Mental Health Trajectories of Children and Caregivers Who Accessed School-Based Health Centers During the COVID-19 Pandemic
Sunday, April 30, 2023
3:30 PM – 6:00 PM ET
Poster Number: 715 Publication Number: 715.328
Sloane Freeman, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Saisujani Rasiah, St. Michael's Hospital, Unity Health Toronto, Scarborough, ON, Canada; Justine H. Cohen-Silver, University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada; Keying Xu, St. Michael's Hospital, Toronto, ON, Canada; Jonathon Maguire, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
Research Coordinator St. Michael's Hospital, Unity Health Toronto Scarborough, Ontario, Canada
Background: School-based health centers (SBHC)s improve health care access for students with mental health concerns, especially for disadvantaged communities who face access barriers. During the pandemic, health care access was restricted, however the REACH School Network SBHCs remained accessible. How SBHCs supported children’s and caregivers’ mental health during the pandemic is unclear. Objective: The primary objective of this study was to compare the trajectory of mental health symptoms in children who used SBHCs during the pandemic compared to those who did not. Design/Methods: This was a prospective longitudinal cohort study of children who used SBHCs serving disadvantaged children with developmental and mental health conditions through the REACH School Network. A mental health survey which included the Strengths and Difficulties Questionnaire (SDQ) and the Generalized Anxiety Disorder-7 (GAD-7) was used at three time points during the pandemic for children registered with SBHCs. The primary analysis compared the trajectory of SDQ scores over time between children who accessed the SBHCs during the pandemic and those that did not. The secondary analysis was the same using the GAD-7 scores for caregivers. Results: There were 435 children included in the study. The mean age was 10.7 years (SD=3.2). Two hundred and ninety-five children (67.8%) identified as male. One hundred and twenty-eight (29.4%) children had an annual family income of less than < $30,000.00. After adjusting for age, gender, and diagnoses, children who attended SBHCs had higher SDQ scores over time relative to children who did not (0.15, 95% CI 0.03 to 0.28, p=0.02). Specifically, the total SDQ score increased by 0.14 (95% CI: 0.02, 0.27; p = 0.03) per month in those that accessed SBHCs during the pandemic, while the change in total SDQ score per month was -0.01 (95% CI: -0.06, 0.03; p = 0.55) in those that did not. Caregivers of children who attended SBHCs also had higher GAD-7 scores over time (0.16, 95% CI = 0.06 to 0.27, p = 0.002) compared to those whose children did not visit the SBHCs.
Conclusion(s): Mental health symptoms and anxiety symptoms worsened among children and caregivers who attended a SBHC at least once during the pandemic. SBHCs may have decreased access barriers for children and caregivers with socioeconomic risk factors who experienced mental health symptoms during the pandemic, when other healthcare options were limited. Longitudinal studies with longer follow up would help determine the role of SBHCs in supporting at-risk children with mental health needs during the pandemic.