A Psychiatry Service for Parents of Children With Medical Complexity

BACKGROUND AND OBJECTIVES: Children with medical complexity are caregiver dependent because of complex, chronic health conditions; functional limitations; technology dependence; and high health care use. Their parental caregivers have suboptimal mental health, yet little is known about the psychiatric profiles of this group. We aimed to describe the clinical and demographic characteristics of parents of children with medical complexity seen by an integrated psychiatry service. METHODS: This is a descriptive case series using retrospective medical record review of electronic medical records from 2020 to 2023. We developed a novel psychiatry service in partnership with a pediatric complex care program for diagnostic assessment and treatment of parental caregivers of children with medical complexity in Toronto, Ontario. We included all parents of children with medical complexity who were seen by the psychiatry service for assessment and treatment of suspected mental illness (n = 57). RESULTS: Most parents received a new diagnosis (79%); the most common diagnoses were depressive disorders (67%), anxiety disorders (65%), and trauma- and stressor-related disorders (56%). Common treatment recommendations included psychotherapy (95%) and medication (75%). The sample was 84% female with a mean age of 42 years (SD 6 years). All consultations occurred virtually. CONCLUSIONS: We identified a high number of treatable psychiatric illnesses in the referred parents. Partnerships between pediatric complex care teams and psychiatry services and using virtual care may help with timely and accessible mental health care for this at-risk population. Future research could investigate adherence to and efficacy of treatment recommendations for this caregiver population.