Abstract
Children with medical complexity (CMC) are a medically fragile subset of children
who often rely on parental caregivers for substantial care needs. Caregivers of CMC
often experience adverse health outcomes such as depression and anxiety, sleep deprivation,
financial hardships, and social isolation. Caregivers of CMC are at risk of premature
mortality, which is thought to be mediated by chronic and elevated stress, as well
as psychiatric morbidity risk. Access to mental health care, where the needs of both
the caregiver and child are considered, can enable caregivers to meet high caregiving
demands and improve both child and caregiver outcomes. We describe the Caring for
the Caregiver (C4C) model, a novel integrated stepped care model consisting of a collaboration
between a psychiatrist and a paediatric complex care program. This model provides
support in 3 steps: 1) early identification of distress, 2) social work support and
psychotherapy, and 3) psychiatric care, including diagnosis or medication initiation,
for caregivers of CMC. This innovative model will be the first to embed support for
the mental health needs of caregivers of CMC within a paediatric team, facilitating
access to psychiatric care and serving as a foundation for future integrated stepped
care models.
Keywords
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Article Info
Publication History
Accepted:
June 1,
2022
Received:
December 13,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Published by Elsevier Inc. on behalf of Academic Pediatric Association
