Only 37% of children on Medicaid received mental health services within six months of experiencing a firearm injury, according to a new study.
“Overall, our findings suggest opportunities are available for trauma centers and pediatricians within the medical home to take a comprehensive approach to postinjury care that uses a broader definition of recovery, encompassing psychosocial health and well-being,” authors wrote in “Timing of Mental Health Service Use after a Pediatric Firearm Injury,” (Hoffmann JA, et al. Pediatrics. June 5, 2023).
Being injured by a firearm can be a traumatic experience triggering a variety of mental health concerns. Researchers analyzed data on 2,613 children ages 5-17 years with Medicaid who experienced a nonfatal firearm injury from 2010-’18.
About 37% of these youths used mental health services within six months of their injury. About 40% of that group had not used mental health services previously.
Substance use/addiction disorders and trauma/stress disorders were the most common new disorders among children seeking mental health care. While less common, the rates of bipolar disorder, schizophrenia spectrum disorders and suicidal ideation/self-injury nearly doubled.
Children were more likely to seek mental health services after a firearm injury if they previously received mental health care, received a mental health diagnosis while being treated for the firearm injury or the injury left them with a new complex chronic condition, according to the study.
Data also showed White children had higher odds of using mental health services than Black children. Authors said this could be due to a variety of factors, including stigma, cost and limited availability of nearby mental health professionals.
“Attention is needed to address barriers at the individual, health system and societal levels that may prevent Black youth from accessing MH (mental health) services,” they wrote.
Just over half of children seeking outpatient mental health services did so within a month of their injury. Those seeking mental health care quickly were likely to have a history of mental health service use.
Authors noted their findings were limited by data coming only from children with Medicaid in 11 states. They did not look at the percentage of children who needed mental health services or those who were not able to access services.
Still, they urged trauma centers and pediatricians treating children with firearm injuries to screen for mental health conditions and include mental health professionals on care teams.
“To mitigate the adverse effects of firearm injuries on child health outcomes, public health strategies should prioritize early detection of MH needs, equitable access to MH care, and timeliness of care,” they wrote.
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