Universal Psychosocial Screening Using MyHEARTSMAP In Hospitalized Pediatric Patients: A Randomized Control Study

Purpose/Objective: The goal of this project is to investigate if implementing universal psychosocial screening using the MyHEARTSMAP instrument in hospitalized pediatric patients admitted for non primary psychiatric concerns increase/affect their holistic biopsychosocial management.

Hypothesis/Justification: Mental health conditions represent an increasingly substantial burden of illness in the pediatric population. Especially among youth who are hospitalized or experiencing chronic illness, there is a disproportionate burden of mental health concerns. However, large proportion of children who screen positive for mental health concerns while in hospital have never been identified as having a mental health concern, or have received health or social services related to such concerns.

The American Academy of Paediatrics has advocated for the universal use of efficient, culturally sensitive, and age-appropriate mental health screening tools to detect and facilitate management of youth with psychiatric illnesses; however, this has yet to be effectively implemented. Currently, in Canada, anecdotal evidence suggests that the standard of care for screening mental health related concerns in hospitalized youth typically varies by treating specialty. The lack of a consistent, systematic approach to screening youth coupled with reduced screening among those with higher medical needs may result in vulnerable pediatric populations falling through gaps of care in medical systems. In order to address the issue of under-identification of mental health illness in youth requiring hospitalization, this study proposes to implement a universal mental health screening using an online self-assessment tool, MyHEARTSMAP, in hospitalized youth to allow for early screen of mental health conditions and to improve their holistic biopsychosocial care.

MyHEARTSMAP has been validated as a universal screening tool and, when compared to clinician reports, has high sensitivity and specificity to identify youth with psychosocial concerns that warrant further follow-up. Upon completion of the tool, MyHEARTSMAP produces triggered recommendations that are consistent with clinician assessment. This tool has been adapted from HEARTSMAP, a clinical assessment tool used by British Columbia (BC) Children's Hospital Paediatric ED clinicians for mental health assessment and management of youth presenting with mental health concerns. Designed for self-assessment and universal screening, MyHEARTSMAP allows children and their parents to efficiently self- and proxy-report across multiple domains of mental health. MyHEARTSMAP allows for the comprehensive evaluation of 10 areas of wellbeing that makeup the 'HEARTSMAP' acronym: Home, Education and activities, Alcohol and drugs, Relationships and bullying, Thoughts and anxiety, Safety, sexual health, Mood, Abuse, and Professional resources.

Study Design, Population and Setting: The investigators propose to conduct a prospective randomized controlled study to evaluate the impact of standardized psychosocial screening using MyHEARTSMAP upon admission to an in-patient ward, on the frequency of psychosocial intervention during the hospitalization or mental health resource referrals upon discharge.