Screening parents of children with a chronic condition for mental health problems: a systematic review

Objective Parents of children with a chronic condition (CC) have a high prevalence of mental health (MH) difficulties. It is not known whether establishing screening programmes in paediatric clinics to identify parental MH difficulties increases detection or referrals to support services. We aimed to identify approaches to routine screening programmes for parents of children with a CC attending hospital outpatient clinics (aim 1); associated prevalence of MH symptoms (aim 2); and whether screening impacted referrals to, and uptake of, MH services (aim 3). Design Medline, Embase, PsycINFO, CINAHL and PubMed databases were searched between January 2000 and December 2023. Studies were selected if they conducted routine screening of MH of parents of children with CCs (aged <18 years). Study characteristics, population demographics and information on screening tools, MH symptoms and referral pathways were extracted. Results Eight articles met the inclusion criteria from 8673 screened. The prevalence of elevated parental MH symptoms ranged between 9.6% and 62.9% for anxiety and 7.7% and 57.0% for depression. Two studies using the Distress Thermometer for Parents found 3.3%-57.0% had elevated levels of 'clinical distress'. There was limited detail on referral pathways, referrals made and uptake. Conclusions Elevated MH symptoms are common in parents of children with CCs, but there is wide variability in outcomes. More research is required to understand this and how best to identify and screen for and support parents with referrals to and uptake of services for their MH. PROSPERO registration number CRD42023438720.