Universal psychosocial screening in hospitalized pediatric patients: A randomized control trial

Introduction: A validated psychosocial self-screening tool, MyHEARTSMAP, was used to screen hospitalized children, who often experience disproportionate mental health burdens. The primary objective compared the proportion of participants receiving psychosocial intervention between those with and without MyHEARTSMAP screening. Secondarily, we explored the utilization of resources at 3 months post-discharge.

Methods: This randomized control trial was conducted in an emergency department, enrolling 289 children being admitted. The intervention group completed MyHEARTSMAP, and results were shared with clinicians. The control group received standard care and completed MyHEARTSMAP following discharge. Health records were reviewed to document in-hospital management. Descriptive statistics and logistic regression modeling were used to evaluate the association between screening and intervention.

Results: Psychosocial intervention rates were higher in the intervention group (40.4%) than the control (32.9%), though this was not significant (RR = 1.28, 95% CI [0.95, 1.73], p = .109). Among those with positive screening results, the intervention group had a statistically significant higher proportion of psychosocial intervention (41.3%) than the control (25.1%) (RR = 1.60, 95% CI [1.04, 2.46], p = .0318). At 3 months post-discharge, engagement with recommended services was overall modest. 

Conclusions: Universal screening can identify youth at higher risk of psychosocial burden, and MyHEARTSMAP shows promise as a low-barrier tool for addressing the psychosocial needs of children.