Family Functioning Screening, Referral, and Behavioral Health Utilization in a Family Medicine Setting

Youth receive inadequate treatment for their behavioral health conditions (BHCs; e.g., ADHD, Depression, Anxiety), with only 20% of youth with diagnoses receiving treatment for their condition (American Academy of Pediatrics, [...]
Introduction: The objective of this study was to determine the preliminary feasibility and acceptability of screening for family functioning in a family medicine setting, and secondarily to explore differences in parent-child dyad interest in behavioral health service utilization by demographics, pediatric behavioral symptoms, and pediatric QOL. Method: The McMaster Family Assessment Device General Functioning subscale was used to assess family functioning among 58 parent-child (ages 11-26) dyads in family medicine. Feasibility and acceptability were assessed through study interest and participation and interest and attendance in behavioral health services. Associations with interest in services, Child Behavior Checklist, Pediatric QOL Inventory, and select demographics were conducted using independent samples t-tests and Mann-Whitney tests. Results: Fifty-eight parent-child dyads participated in the study. Close to half of dyads who expressed interest in the survey completed the assessment (46%). Dyads who completed the assessment had a family functioning impairment rate of 45%, and 54% of dyads with impairment expressed interest in services. Interest in services was significantly associated with several domains of childrens' behavioral health symptoms and pediatric QOL, but no demographics. Discussion: Dyads experienced high rates of clinically significant family functioning impairment, without interest in receiving colocated behavioral health services. Future research should continue to explore how family functioning assessment can be utilized to identify child behavioral health symptoms broadly and engage families in colocated behavioral health services. Public Significance Statement The present study can be used to indicate that family functioning should be screened for in family medicine, since parent-child dyads in family medicine experience high rates of clinically significant family functioning impairment. Additionally, interest in utilizing services was significantly associated with incongruent family functioning impairment reporting by dyad, higher child behavioral health symptoms, and lower pediatric quality of life. Keywords: family functioning, psychosocial screening, family medicine, integrated care