• Pediatr Crit Care Me · Dec 2023

    Mental Health Provision in PICU: An Analysis of Referrals to an Embedded Psychologist Over 20 Years at a Single Center.

    • Gillian A Colville.
    • Paediatric Psychology Service, St George's University Hospitals NHS Foundation Trust, London, United Kingdom.
    • Pediatr Crit Care Me. 2023 Dec 1; 24 (12): e592e601e592-e601.

    ObjectivesThe main aim of this study was to illustrate the type of mental health provision possible on PICU by describing the nature of referrals of child patients and their parents to an embedded psychologist over a 20-year period, adding to the literature on intervention and service development.DesignRetrospective evaluation of anonymized departmental database.SettingTwelve-bed PICU at a teaching hospital in a major urban center.PatientsFive hundred forty-five consecutive referrals for support for parent and/or child by PICU staff between 1998 and 2017.InterventionsNone.Measurements And Main ResultsReferrals increased from seven of 288 (2.4%) in 1998 to 85 of 643 (13.2%) in 2017. The majority were for parent support initially (456/545, 84%). Mean ( sd ) number of contacts was 4.5 (10.2), range 1 to 143, and mode was 1. Patient gender and age typical of the total PICU population, but referrals were more common where children had an oncology or trauma diagnosis ( p < 0.001). Comparisons with other inpatient referrals at the same hospital revealed a higher proportion of requests were made for parent support on PICU (456/545 [84%] vs 789/1,997 [40%]; p < 0.001) and that nurses were more likely to initiate referrals on PICU than on the other wards (437/543 [80%] vs 1,190/1,993 [60%]; p < 0.001). In other respects, the two groups were similar in terms of number of sessions, waiting times, and attendance rates.ConclusionsGrowing appreciation of the psychological impact of a child's admission to PICU has been associated with increasing referral to an embedded psychologist over a 20-year period, at this center. Clinical and service implications are outlined in the context of the latest research on the mitigation of post-intensive care syndrome in this population.Copyright © 2023 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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