Infectious Disease

Motivational interviews cannot increase the use of mental health care by adolescents

October 12, 2021

Read for 2 minutes

Source / information

Disclosure:
One study author reports personal fees from Abbvie, Novartis, and Pfizer outside of the work submitted. The other authors do not report any relevant financial information.

ADD SUBJECT TO EMAIL ALERTS

Receive an email when new articles are published on

Please enter your email address to receive an email when new articles are published on . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If this problem persists, please contact customerservice@slackinc.com.

Back to Healio

Motivational interviews during specialized pediatric consultations did not increase the use of mental health services in adolescents and young adults with chronic illnesses, according to a randomized clinical cluster study.

However, it correlated with longer conversations between patients and doctors and lower anxiety scores after 1 year.

Source: Adobe Stock

“Recognizing mental disorders and providing adequate treatment options are important factors for starting therapy”, Christina Reinauer, MD, of the University Children’s Hospital Düsseldorf in Germany, and colleagues wrote in the JAMA Network Open. “Validated tools to identify comorbid mental health problems and short psychological interventions such as motivational interviews (MI) are applicable.

“MI is an evidence-based, collaborative counseling technique that explores intrinsic motivation and ambivalence,” they added.

Results from previous studies showed that MI increased increased therapy uptake in suicidal patients, as well as uptake of cognitive behavioral therapy or online interventions in depression in adolescents. Other studies outlined the possibility of introducing MI into the clinical routine to improve the uptake of psychiatric care in young patients.

In the current study, Reinauer and colleagues wanted to evaluate whether MI training for paediatricians could promote the use of mental health care among adolescents. They randomly assigned a 2-day MI workshop or a usual treatment in clusters treated by pediatricians from a single children’s hospital. Patient recruitment and MI interviews took place between April 2018 and May 2020. The study also included a 6-month follow-up and a 1-year rescreening.

A total of 164 people between the ages of 12 and 20 with chronic illnesses and comorbid anxiety and depression symptoms (59% girls / women; mean age 15.2 years) were advised by an MI-trained or untrained doctor on access to psychological counseling.

The researchers used a logistic blended model, which they had fitted to the cluster structure of the data, to analyze use of mental health services within the 6 month follow-up, with this use as the primary endpoint. They defined admission as the agreement of one or more appointments up to a 6-month follow-up.

Ninety-four (57%) of the participants received MI and 70 (43%) treatment as usual. Patients whose physicians received MI training showed no statistically significant difference in the use of psychiatric care compared to patients who received normal treatment after 6 months. The subjective burden of disease moderated the effect. The researchers found lower levels of anxiety symptoms in those who received advice from an MI-trained doctor after a year of repeat screening. The MI training correlated with longer conversations between the patient and the doctor, with the duration of the conversation significantly influencing the admission rates under all conditions.

“The MI approach can help break down barriers and stigma associated with psychological concerns,” the researchers write. “Involving pediatricians as facilitators of mental health treatment in a collaborative care setting is a potentially effective and sustainable approach to addressing current treatment gaps.”

In a related editorial Marie-Eve Robinson, MD, MSc, of the Children’s Hospital of Eastern Ontario in Canada, stressed the importance of length of conversations between patients and doctors.

“Although it seems intuitive that more time with patients could improve certain behaviors, the work of Reinauer and colleagues on this point is particularly instructive, as it has shown that the length of conversation between the pediatrician and the adolescent is associated with an increased mental health uptake “Services,” wrote Robinson. “This suggests that pediatricians could spend more time advising their patients, at least those with moderate to severe psychiatric disorders who clearly need referral to appropriate mental health services.”

ADD SUBJECT TO EMAIL ALERTS

Receive an email when new articles are published on

Please enter your email address to receive an email when new articles are published on . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If this problem persists, please contact customerservice@slackinc.com.

Back to Healio

Related Articles