Mental health problems among adolescents and young adults with childhood-onset physical disabilities: A scoping review

Abstract

AimThis scoping review aims to better understand the extent and nature of research activity on the topic of mental health problems in young people with childhood-onset physical disabilities. Specifically, we document what has been investigated in terms of the occurrence and experience of mental health problems among young people with childhood-onset physical disabilities, and their access to mental health services.MethodsWe searched four databases (Medline, PsycINFO, CINAHL, Embase) for articles published between 2007 and 2019. Studies were included if they addressed: (1) young people between the ages of 13 and 24 with a childhood-onset physical disability, and (2) mental health assessment, treatment, or service access and use.ResultsWe identified 33 peer-reviewed studies that focused mainly on young people with cerebral palsy, juvenile arthritis, and spina bifida. The most common mental health problems investigated were depression and mood related difficulties (73%), anxiety (39%), and social/behavioural issues (33%) and the most common age range was 13 to 17. Ten studies explored access, use, and experiences of mental health services; stigma; caregiver mental health; and value for comprehensive care, using qualitative, quantitative, or mixed methods.ConclusionsFindings suggest the importance of developing integrated models of service delivery to identify and address the mental health needs of this population, and consensus on best practices for assessment and reporting rates of subclinical symptoms and psychiatric conditions.

Organization of rehabilitation services for youth with physical disabilities and mental health problems: A scoping review

“…Using the PCC framework (Population/Participants, Concept, Context) and building on the previous scoping review findings ( 4 ), this review aimed to answer the following research question: What is known about existing health and rehabilitation services and models of service delivery for youth with co-occurrence of childhood-onset physical disabilities and mental health problems? Additional sub-questions include: 1) How are these services organized and delivered?…”

“…The search terms included four topics and their derivatives: physical disability, mental health disorder, youth, and healthcare service. The initial search strategy was developed for Medline, building on previous scoping reviews ( 4 , 21 ) and as seen in Table 1 . It was then adapted to the other databases with input from the university librarian to specifically target the organization of services.…”

“…Additionally, mental health is often overlooked when clients are treated for chronic physical conditions ( 3 ). A recent scoping review carried out by our team ( 4 ) also revealed that symptoms of depression and mood-related difficulties, followed by anxiety and social and behavioral difficulties are frequently present in adolescents and young adults with physical disability such as spina bifida and Duchenne muscular dystrophy. Despite the high occurrence of mental health disorders, symptoms or behavioral problems, few studies included in the review addressed access to, and organization of, mental health services.…”

“…Indeed, little is known about how health and rehabilitation services address the mental health needs of youth with childhood-onset physical disabilities. Thus, our team first carried out a scoping review to explore the rates of co-occurrence of mental health problems among adolescents and young adults with a physical disability, and also to describe if they had access to mental health care ( 4 ). Only 10 out of the 33 retained articles addressed access to services, which led to four related themes: use, access, and experiences of mental health services; stigma; mental health of family caregivers; and the value of comprehensive mental health services.…”

“…Few participants who had mental health concerns accessed services, and many unmet needs were reported. Despite a push for more, or better access to, mental health services for those with physical disabilities, no article from that scoping review detailed how such services could be organized to fit with existing systems of care ( 4 ). Therefore, it was established that the cooccurrences were prevalent, but it remained unclear how services were organized and delivered.…”