THE ROLE OF ONTARIO’S FIRST SCHOOL-BASED HEALTH CLINIC IN ACCESSING DEVELOPMENTAL AND MENTAL HEALTH CARE FOR CHILDREN FROM INNER CITY ELEMENTARY SCHOOLS: A RETROSPECTIVE CHART REVIEW
Notice bibliographique
Résumé
BACKGROUND: Children with developmental and mental health challenges face an uphill battle to reach the academic milestones of their peers. These challenges are exacerbated by social inequity. Early access to developmental and mental health assessments has been shown to improve long-term outcomes. Unfortunately, the wait-time for developmental assessment in Ontario is 15.5 months and the wait-time for mental health assessment in Ontario has not been well documented. The first School-Based Health Clinic (SBHC) in Ontario was established through the Model Schools Pediatric Health Initiative as a partnership between St. Michael’s Hospital and the Toronto District School Board. The clinic was modeled after SBHCs in the United States which provide comprehensive medical and mental health care to underserved children. A feasibility study conducted in 2012 during the first eight months of the program demonstrated 20% of SBHC users went on to receive a developmental assessment. The current proportion of users receiving a developmental or mental health assessment at the SBHC and wait-times to assessment has not been explored. OBJECTIVES: To assess the impact of a School-Based Health Clinic on wait-times for developmental assessments and mental health care for inner-city children. DESIGN/METHODS: A retrospective chart review was performed on 404 children aged 4–14 with at least one visit to an inner-city School-Based Health Clinic from 2011–2014. Developmental impact measures included the proportion of children presenting with a developmental concern and the wait-time for receiving a developmental assessment. Mental health impact measures included the proportion of children with mental health concerns, proportion of children with new mental health diagnoses, proportion of children receiving a referral to a mental health professional, and wait-times for receiving a mental health diagnosis. RESULTS: Of the 404 children with at least one visit to the School-Based Health Clinic, 71.3% had a developmental concern and the wait-time for receiving a developmental assessment was 27.6 weeks. Mean age of children receiving a developmental assessment was 7.0 years. With respect to mental health impact, 55.9% presented to the school clinic with at least one mental health concern, 13.6% received a new mental health diagnosis including at least one of attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, depression, anxiety disorder, or selective mutism, and 25.7% of the children received a referral to a psychiatrist or psychologist. The wait-time for receiving a mental health diagnosis was 27.1 weeks. CONCLUSION: School-Based Health Clinics are an effective and feasible model to decrease wait-times for receiving developmental assessments and to provide mental health services to inner-city children.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,009 | 0,011 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».