Behavioral Health Support Research Articles

CHaMP: A Model for Building a Center to Support Health Care Worker Well-Being After Experiencing an Adverse Event.

With an already distressed health care workforce demonstrating high levels of burnout, depression, and suicide, access to behavioral health care, particularly after an adverse event, is critical. Unfortunately, clinicians identify multiple barriers to seeking behavioral support. In 2022 the National Academy of Medicine, in its National Plan for Health Workforce Well-Being, established "Support Mental Health and Reduce Stigma" as one of its seven priority areas. The authors developed a program called CHaMP (Center for Healthy Minds and Practice) guided by a multidisciplinary task force that developed the vision, plan, and algorithms to improve crisis response; build a peer support program; and remove barriers to accessing mental health care by establishing an on-campus behavioral health support center. This program was implemented using Kotter's 8-step Model of Change. Within the first months of establishing this program, the support team responded to multiple activations of the crisis response plan, built a peer support program, and provided counseling services to 631 employees. During the COVID-19 pandemic, CHaMP played a central role in the support of all employees. This program and its implementation based on Kotter's 8-Step Model of Change was a powerful and practical methodology to design and implement interventions to address system and individual factors that affect clinician well-being and resilience after an adverse event.

Analysis of the Prison Justice Reforms Act

Purpose: The aim of the study is to analyze the Prison Justice Reform Act
 Methodology: This study adopted a desktop methodology. This study used secondary data from which include review of existing literature from already published studies and reports that was easily accessed through online journals and libraries.
 Findings: The study shows that rehabilitation and education programs were major reforms introduced in prisons. Rehabilitation programs aimed at enhancing job readiness, seeking skills, which equip the inmate with job search techniques and job behavioral health support. The study also shows that prison education programme was found to be of great benefit to the ex-convicts and the benefit trickle down to the community at large.
 Unique Contribution to Theory, Practice and Policy: The study was anchored on Cognitive behavior modification theory and legitimacy theory. The study recommended that prisons should focus on the importance of incorporating the knowledge of rehabilitation programs of initiative into the mainstream private sector and public policy decision making.

The Official Journal of ATTD Advanced Technologies & Treatments for Diabetes Conference 22‐25 February 2023 I Berlin & Online

The Official Journal of ATTD Advanced Technologies & Treatments for Diabetes Conference 22‐25 February 2023 I Berlin & Online

Youth Offenders and Rehabilitation: Insights from Legal Practitioners and Social Workers

The objective of this study was to explore the perspectives of legal practitioners and social workers on the rehabilitation of youth offenders. It aimed to identify the challenges and opportunities within the rehabilitation process, with a focus on understanding the multifaceted approach required for effective rehabilitation and reintegration into society. A qualitative research design was employed, utilizing semi-structured interviews with a purposively selected group of 27 legal practitioners and social workers involved in the rehabilitation of youth offenders. Data were analyzed using thematic analysis to identify key themes and categories related to the rehabilitation process. The analysis revealed four main themes: Public Perception and Policy, Rehabilitation Challenges, Individualized Rehabilitation Strategies, and Community Integration and Support. These themes encompassed various categories, including media influence, legislative support, gang affiliation, resource limitations, education and skill development, behavioral and mental health support, family engagement, peer networks, and post-release services. The findings highlight the complexity of rehabilitating youth offenders and emphasize the need for a holistic approach that addresses individual needs and leverages community support. The study concludes that effective rehabilitation of youth offenders requires a comprehensive approach that goes beyond punitive measures. It underscores the importance of addressing public perceptions, providing legislative support for rehabilitation programs, tailoring strategies to individual needs, and ensuring robust community integration and support systems. The insights from legal practitioners and social workers offer valuable directions for developing policies and practices that can more effectively support the rehabilitation and reintegration of youth offenders.

BEYOND HOUSING

Abstract Social isolation and loneliness in older adults are a public health challenge that has been exacerbated during the COVID pandemic. While quarantining although it was necessary to protect individuals from the virus, older adults lost their usual social supports, connectedness, and relationships. Research has shown that loneliness and social isolation have many negative effects on a person’s physical and mental health. This presentation will describe an initiative of Age Friendly RI which addressed the problem of social isolation among older adults living in a congregate housing community who struggled with stress, anxiety, depression, and exacerbation of mental illness. Through a partnership between a state college and a community based mental health center, and supported with grant funding, behavioral health services and supports were embedded in the housing community. The project was multi-faceted involving community health workers and a community support professional who provided outreach and emotional support, the use of technology to help residents connect with medical providers or loved ones or enjoy music, games, movies, and students who provided outreach and taught older adults how to use technology. A social isolation scale was administered to identify residents at high risk of social isolation and targeted intervention. The evaluation of the program will be discussed in terms of the interventions implemented and the outcomes realized, including resident well-being and satisfaction. Finally, it will suggest a pathway for sustaining the integration of behavioral health services in housing to better meet the behavioral health needs of older residents beyond the pandemic.

A Qualitative Evaluation of an Adapted Assertive Community Treatment Program: Perspectives During COVID-19.

The Pinellas County Empowerment Team (PCET) was an adapted assertive community treatment (ACT) program created to meet the needs of Pinellas County residents with serious behavioral health concerns and high frequency of hospitalization (medical and psychiatric) and incarceration. Recent research demonstrates that individuals participating in ACT programs can transition to lower-intensity services. To understand the needs and barriers in transitioning PCET clients to lower-intensity services and the unique experiences during the coronavirus (COVID-19) pandemic, the researchers conducted a qualitative evaluation which includes a case record review and in-depth interviews with clients of PCET and staff members. Our findings indicated several barriers to transitioning PCET clients, including a lack of sufficient behavioral health support outside the ACT program and some clients' concerns regarding their abilities once out of the program.

Task Sharing to Expand Access to Care: Development of a Behavioral Health Support Specialist.

Task sharing improves access to mental health care in many countries, but little formative research has examined uptake in the United States. This Open Forum proposes the development of nonspecialist professional roles to deliver low-intensity behavioral interventions for common mental health conditions in U.S. settings such as primary care. Using data from a multilevel stakeholder assessment, the authors discuss findings and challenges associated with such a role. Key themes from stakeholder surveys concerned scope of practice, competencies, pragmatic concerns, and training needs. Although stakeholders generally found this role to be acceptable and feasible, the themes raised will be critical to developing and implementing such a role.

Psychiatrists' Involvement in a Public Health Response to Human Trafficking.

Back to table of contents Previous article Next article Frontline ReportsFull AccessPsychiatrists’ Involvement in a Public Health Response to Human TraffickingRachel Robitz, M.D., Priti Ojha, M.D., Steve Koh, M.D., M.P.H.Rachel RobitzSearch for more papers by this author, M.D., Priti OjhaSearch for more papers by this author, M.D., Steve KohSearch for more papers by this author, M.D., M.P.H.Published Online:18 Oct 2022https://doi.org/10.1176/appi.ps.20220430AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Human trafficking is increasingly being viewed through a public health lens, which allows us to address it as an issue that affects health. With this approach, psychiatrists can focus on preventive measures and on the health care needs of individuals who have experienced trafficking. Psychiatrists in San Diego have partnered with the local community to address trafficking through clinical services and development of policies for identification and appropriate care of trafficking survivors.Clinical work began when a University of California, San Diego (UCSD), family medicine–psychiatry resident (R.R.) with an interest in working with this population developed relationships with community organizations. Many organizations used therapists to provide behavioral health support, but they were unable to access trauma-informed psychiatric services in a timely fashion. To improve access to high-quality care, the resident began seeing patients via both residential and outpatient programs for sex trafficking survivors, initially within a self-designed elective rotation and then during formal rotations through UCSD’s community psychiatry program.The clinical sites included a federally qualified health center and a county-funded specialty clinic that together have served more than 100 patients who have been trafficked for sex. All women at a residential treatment program for survivors of sex trafficking were enrolled as patients. They received their primary care from family medicine residents trained by the family medicine–psychiatry resident in providing care for survivors of human trafficking, and they received psychiatric care from psychiatry residents. The primary psychiatrist (R.R. or P.O.) maintained regular contact with treatment program staff, when patients gave consent to do so, to ensure a unified treatment plan. Patients received group and individual trauma-based therapies through the residential treatment program as well as educational, life skills, and arts-based group sessions. Most women remained in the program for 6–12 months. The county-funded specialized clinic provided services to youths who experienced or were at risk of commercial sexual exploitation. Services included case management and individual and group psychotherapy. The psychiatrist (P.O.) collaborated closely with therapists and case managers, who often attended sessions to enhance the trauma-informed approach.UCSD also formed a multidisciplinary committee, now cochaired by a community psychiatrist (P.O.), comprising UCSD faculty, nurses, social workers, medical trainees, and community partners. The committee developed and implemented a policy and screening protocol with guidance from a protocol development tool kit from HEAL Trafficking and Hope for Justice. The protocol includes guidance on how to assess patients for signs of human trafficking, steps for providing a trauma-informed response, and an overview of how and when to engage law enforcement or child protective services. Additionally, the committee hosts an annual human trafficking awareness event to educate health system staff and encourage collaboration. Tools to educate health system staff about both human trafficking and trauma-informed care are being developed.There were several barriers to developing psychiatric services for this population. Few psychiatrists have expertise in working with this population, and the original work in San Diego County was completed by a resident with limited topic-specific supervision. Clinical barriers included occasional difficulties in communication because of a lack of a centralized area for exchange of medical information. Also, psychiatrists often lack awareness and knowledge about human trafficking and how to address it in clinical settings. Many other programs in the area also had funding restrictions, which limited services to certain age groups or types of trafficking. These barriers limit access to needed services for several populations, including survivors of labor trafficking and male survivors of trafficking.Psychiatry has a critical role to play in the public health response to human trafficking. Because this is a relatively novel area of medicine, there is ample room for expansion. We continue to develop educational tools and evaluate and expand our protocol. This early work has focused on sex trafficking. However, we must also consider the needs of labor trafficking survivors, who are rarely offered treatment and have frequently experienced trauma. Overall, these activities demonstrate that psychiatrists can be involved in a multipronged approach to addressing human trafficking as a public health issue.Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Robitz); Department of Psychiatry, University of California, San Diego, La Jolla (Ojha, Koh).Send correspondence to Dr. Robitz ([email protected]).The authors report no financial relationships with commercial interests. FiguresReferencesCited byDetailsCited byNone Volume 74Issue 2 February 01, 2023Pages 212-212 Metrics KeywordsPublic healthAdministration and managementTraumaWomen’s healthPDF download History Published online 18 October 2022 Published in print 1 February 2023

Black Men Who Have Sex with Men with HIV and Providers in HIV Care Settings Reflect on Stigma Reducing Strategies to Promote Engagement in Health Care.

Black men who have sex with men (BMSM) with HIV face significant challenges in accessing health care, including routine HIV care and behavioral health care due in part to perceived stigma in health care settings. This study examined the perspectives of BMSM with HIV and health care providers of how stigma experiences can affect health care access to both clinical and behavioral health support services. We explored how providers can mitigate stigma practices and improve health care experiences for BMSM with HIV, which may ultimately improve engagement in care. Working with eight sites as part of the BMSM Initiative, we recruited 20 BMSM with HIV and 13 health care providers to participate in individual virtual interviews. Participants were asked about perceived discrimination and stigma experienced by BMSM with HIV and strategies to reduce stigma experiences. Participants discussed how current practices could be improved to reduce stigma and how the use of telehealth promoted engagement in care. Recommended strategies to reduce stigma in HIV care delivery included offering personable communication, providing nonclinical resources along with standard HIV care, requiring staff diversity training, diversifying health care teams, and offering telehealth options. Employing stigma reduction strategies can create a safe and comfortable environment for BMSM with HIV to engage in behavioral care in HIV care settings. Providers should seek to incorporate these strategies into current and future models of care with the goal to improve overall health outcomes in BMSM with HIV.

Barriers and Potential Solutions to Implementing Evidence-Based PTSD Treatment in Military Treatment Facilities.

Prolonged exposure therapy is an effective treatment for posttraumatic stress disorder that is underutilized in health systems, including the military health system. Organizational barriers to prolonged exposure implementation have been hypothesized but not systematically examined. This multisite project sought to identify barriers to increasing the use of prolonged exposure across eight military treatment facilities and describe potential solutions to addressing these barriers. As part of a larger project to increase the use of prolonged exposure therapy in the military health system, we conducted a needs assessment at eight military treatment facilities. The needs assessment included analysis of clinic administrative data and a series of stakeholder interviews with behavioral health clinic providers, leadership, and support staff. Key barriers were matched with potential solutions using a rubric developed for this project. Identified facilitators, barriers, and potential solutions were summarized in a collaboratively developed implementation plan for increasing prolonged exposure therapy tailored to each site. There was a greater than anticipated consistency in the barriers reported by the sites, despite variation in the size and type of facility. The identified barriers were grouped into four categories: time-related barriers, provider-related barriers, barriers related to patient education and matching patients to providers, and scheduling-related barriers. Potential solutions to each barrier are described. The findings highlight the numerous organizational-level barriers to implementing evidence-based psychotherapy in the military health system and offer potential solutions that may be helpful in addressing the barriers.

Complex PTSD and Forced Migration of Children and Adolescents from Latin America

In order to provide culturally competent care to children and adolescents that have been subject to forced migration, clinicians must first understand the unique trauma these individuals experienced. Victims of forced migration frequently experience trauma pre-displacement, typically resulting from the same factors that led to the forced migration. They then often experience trauma during the migration itself and post-migration as they settle in a new environment, sometimes without their families if they are unaccompanied minors. An increased risk of developing complex PTSD (C-PTSD) correlates with the number of adverse childhood experiences (ACEs) such as those experienced by children and adolescents that experience forced migration. Understanding the nuances of these traumas and their specific manifestations for the individual child or adolescent is critical for effective behavioral health support. Trauma signature (TSIG) analysis offers clinicians a method to understand the relationship between traumatic events and the physical and psychological consequences to best support these victims.

Rising to the Challenge: How Medical Reserve Corps Volunteers Serve as a Scalable Workforce for Local Health Departments in Response to COVID-19 and Beyond.

Rising to the Challenge: How Medical Reserve Corps Volunteers Serve as a Scalable Workforce for Local Health Departments in Response to COVID-19 and Beyond.

Evidence based opioid weaning with behavioral support – Forum for Behavioral Science Edition

Nationally published guidelines state that many patients prescribed chronic opioids would benefit from gradually reducing and/or eliminating their use of these medications. This is easier said than done. Patients are often resistant or fearful, physicians are often uncomfortable prescribing an opioid taper, and patients often do not get the needed behavioral health support in this process. It is critical to develop a comprehensive behavioral and medical plan, however the field lacks practical approaches to guide physicians (and patients) through this challenge. In this manuscript our team of primary care providers and behaviorists walk through a case involving complex opioid weaning in a Family Medicine residency clinic environment. Through the lens of our patient's case, we will discuss best practices for getting patient buy-in, opioid weaning strategies, behavioral support during the wean, identifying co-morbid opioid use disorders, and deciding on acceptable end points for the taper.

Increased utilization of healthcare services in children with craniosynostosis.

Craniosynostosis is characterized by the premature fusion of at least one cranial suture. Although evidence suggests that patients with both syndromic and nonsyndromic craniosynostosis may benefit from developmental, behavioral, and mental health support, data on utilization of healthcare services are lacking. In this study the authors compared utilization of mental health care, rehabilitation therapies, and other specialty medical services among children with craniosynostosis, children with plagiocephaly, and healthy controls. The Optum Clinformatics Data Mart database was queried to identify 1340 patients with craniosynostosis, of whom 200 had syndromic craniosynostosis. Long-term utilization of mental health care, rehabilitation therapies, and other medical services up to the age of 6 years was calculated. Rates of utilization were compared to healthy controls (n = 1577) and children with plagiocephaly (n = 1249). Patients with syndromic and nonsyndromic craniosynostosis used mental health care, occupational therapy, speech-language pathology, and other medical services at similar rates (p = 0.1198, p > 0.9999, p = 0.1097, and p = 0.8119, respectively). Mental health services were used more frequently by patients with craniosynostosis (11.0% in patients with syndromic craniosynostosis and 7.5% in those with nonsyndromic craniosynostosis) compared to patients in the plagiocephaly (5.0%, p = 0.0020) and healthy control (2.9%, p < 0.0001) cohorts. Rehabilitation therapies were more frequently used by patients with syndromic craniosynostosis and plagiocephaly (16.0% and 14.1%, respectively), which was significantly higher than use by healthy controls (p < 0.0001). Other medical subspecialty services (developmental pediatrics, ophthalmology, optometry, and audiology) were used by 37.0% of patients with craniosynostosis, compared with 20.9% (p < 0.0001) and 15.1% (p < 0.0001) of patients with plagiocephaly and healthy controls, respectively. Among patients with craniosynostosis, utilization did not differ by race or household income, but it was not uniform by age. Whereas ophthalmology utilization did not differ by age (p = 0.1003), mental health care was most commonly used among older children (p = 0.0107). In this study, the authors demonstrate that rates of utilization of mental health care, rehabilitation therapies, and other medical subspecialty services are similar between patients with syndromic and those with nonsyndromic craniosynostosis, but higher than in healthy controls. Although surgical correction may be considered an isolated event, providers and parents need to monitor all children with craniosynostosis-syndromic and nonsyndromic-for developmental and mental health support longitudinally. Future work should explore risk factors driving utilization, including suture involvement, repair type, and comorbidities.

American College of Preventive Medicine: Addressing the Opioid Epidemic Through a Prevention Framework

The opioid epidemic has resulted in significant morbidity and mortality in the U.S. Health systems, policymakers, payers, and public health have enacted numerous strategies to reduce the harms of opioids, including opioid use disorder (OUD). Much of this implementation has occurred before the development of OUD‒related comparative effectiveness evidence, which would enable an understanding of the benefits and harms of different approaches. This article from the American College of Preventive Medicine (ACPM) uses a prevention framework to identify the current approaches and make recommendations for addressing the opioid epidemic, encompassing strategies across a primordial, primary, secondary, and tertiary prevention approach. Key primordial prevention strategies include addressing social determinants of health and reducing adverse childhood events. Key primary prevention strategies include supporting the implementation of evidence-based prescribing guidelines, expanding school-based prevention programs, and improving access to behavioral health supports. Key secondary prevention strategies include expanding access to evidence-based medications for opioid use disorder, especially for high-risk populations, including pregnant women, hospitalized patients, and people transitioning out of carceral settings. Key tertiary prevention strategies include the expansion of harm reduction services, including expanding naloxone availability and syringe exchange programs. The ACPM Opioid Workgroup also identifies opportunities for de-implementation, in which historical and current practices may be ineffective or causing harm. De-implementation strategies include reducing inappropriate opioid prescribing; avoiding mandatory one-size-fits-all policies; eliminating barriers to medications for OUD, debunking the myth of detoxification as a primary solo treatment for opioid use disorder; and destigmatizing care practices and policies to better treat people with OUD.

Implementation Evaluation of HUGS/Abrazos During the COVID-19 Pandemic: A Program to Foster Resiliency in Pregnancy and Early Childhood.

Early life adversity can significantly impact child development and health outcomes throughout the life course. With the COVID-19 pandemic exacerbating preexisting and introducing new sources of toxic stress, social programs that foster resilience are more necessary now than ever. The Helping Us Grow Stronger (HUGS/Abrazos) program fills a crucial need for protective buffers during the COVID-19 pandemic, which has escalated toxic stressors affecting pregnant women and families with young children. HUGS/Abrazos combines patient navigation, behavioral health support, and innovative tools to ameliorate these heightened toxic stressors. We used a mixed-methods approach, guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, to evaluate the implementation of the HUGS/Abrazos program at Massachusetts General Hospital from 6/30/2020–8/31/2021. Results of the quality improvement evaluation revealed that the program was widely adopted across the hospital and 392 unique families were referred to the program. The referred patients were representative of the communities in Massachusetts disproportionately affected by the COVID-19 pandemic. Furthermore, 79% of referred patients followed up with the initial referral, with sustained high participation rates throughout the program course; and they were provided with an average of four community resource referrals. Adoption and implementation of the key components in HUGS/Abrazos were found to be appropriate and acceptable. Furthermore, the implemented program remained consistent to the original design. Overall, HUGS/Abrazos was well adopted as an emergency relief program with strong post-COVID-19 applicability to ameliorate continuing toxic stressors while decreasing burden on the health system.

High School Educator Training by Simulation to Address Emotional and Behavioral Concerns in School Settings: A Randomized Study

The purpose of this study is to examine the impact of an online virtual human role-play simulation in teaching high school educators and staff to identify, talk to, and if necessary, refer students in psychological distress to support services. High school educators (N = 31,144) from 43 US states and 5 American territories completed a baseline survey and then randomly assigned to a wait-list control or treatment group. Participants in the treatment group completed the training simulation which included active learning strategies to teach evidenced-based communication strategies such as motivational interviewing to build skills and shift attitudes. Immediately after the training, treatment group participants completed a post-survey and then a 3-month follow-up survey. Baseline and post-surveys included the validated gatekeeper behavior scale measures which assess attitudinal constructs that predict helping behaviors. Self-reported helping behaviors were collected at baseline from both groups and at the 3-month follow-up for the treatment group. The treatment group participants’ post and follow-up data were compared to the control group’s baseline measures. The treatment group post-training scores were significantly higher (p < .001) than the control group’s baseline scores for all gatekeeper behavior scale attitudinal constructs of preparedness, likelihood, and self-efficacy to engage in helping behaviors. A teacher subsample reported significant increases (p < .001) in the number of students referred to mental health support services when compared to baseline measures of the control group. Role-play simulations hold promise in teaching educators to become the “eyes and ears” of student mental health by empowering them to identify students in psychological distress, engage them in effective conversations about their concerns, and if necessary, make a referral to behavioral health support services. Future studies need to implement measures that document students entering counseling as a result of self-reported referrals and examine the impact of the training on the overall mental health culture within schools. Such studies could lead to simulations being widely adopted to support public health initiatives that address student mental health and wellness.

'I Wish the School Had a Better Understanding of the Diagnosis': parent perspectives on educational needs of students with sex chromosome aneuploidies.

Students with sex chromosome aneuploidies (SCAs) are at increased risk for learning disabilities and often require individualized supports in the school setting. Parents of students with rare disorders such as SCAs possess a unique understanding of their child's educational experiences and play a crucial role in the development of successful school support plans. This international survey study aimed to inductively capture parent perspectives on educational needs and supports for students with SCAs. Parents of youth with SCAs ages 5-21 years (n = 305) provided free-text responses to open-ended questions about their child's education. Qualitative content analysis using a bioecological systems framework resulted in three overarching themes. Overall, parents identified multiple factors related to the SCA diagnosis that act as barriers to learning, a strong need for school-based social and emotional supports, and elusive or incomplete educational support plans. Based on these findings, we recommend developing robust family-school partnerships, increased collaboration between the school and the child's medical team, and acknowledgement of the significant role the genetic condition plays in the educational experiences of students with SCAs. Specific suggestions for school support plans for students with SCAs are explored, such as providing school-based behavioral health supports and explicit teaching of executive function strategies.

In Case You Haven't Heard…

The Biden administration announced March 2 a nationwide tour to address mental health challenges exacerbated by the pandemic, another sign the United States may have reached what the president said in his State of the Union address is “a new moment in the fight against COVID‐19,” USA Today reported. The National Tour to Strengthen Mental Health, led by Department of Health and Human Services (HHS) Secretary Xavier Becerra, aims to hear directly from Americans about the behavioral health challenges they're facing and engage with local leaders to strengthen services. “From small towns to big cities, I'll be traveling nationwide with members of my leadership team to meet with people who have been hit particularly hard, and partnering with local leaders to find ways to save lives in our communities,” Becerra said. Over the next few months, the administration also will announce new initiatives to increase the number of behavioral health professionals and support workers in underserved communities, expand pediatric mental health care access through telehealth services and transition to 988, the new suicide and crisis hotline. Throughout the tour, Becerra also will listen and gather ideas about what more HHS can do to address issues like substance abuse, youth mental health and suicide.

493 Increased Utilization of Healthcare Services in Children with Craniosynostosis

INTRODUCTION: Craniosynostosis is a condition characterized by the premature fusion of at least one cranial suture. While evidence suggests that both syndromic and nonsyndromic patients may benefit from developmental, behavioral, and mental health support, data on utilization of healthcare services is lacking. METHODS: The Optum Clinformatics® DataMart database was queried to identify 1340 patients with craniosynostosis. Long-term utilization of mental health care, rehabilitation therapies, and other medical services up to age six was calculated. Rates of utilization were compared to healthy controls (n = 1577) and children with plagiocephaly (n = 1249). RESULTS: Mental health care was utilized more frequently in craniosynostosis patients (8.1%) compared to plagiocephaly (5.0%, p=0.0020) and healthy controls (2.9%, p&lt;0.0001) . Physical, occupational and speech therapy were more frequently used by plagiocephaly than craniosynostosis patients (14.1% vs. 11.2%, p = 0.0283), which was significantly higher than use by controls (11.2% vs. 3.9%, p&lt;0.0001). Other medical subspecialty services (developmental pediatrics, ophthalmology, optometry and audiology) were utilized by 37.0% of craniosynostosis patients, compared with 20.9% (p&lt;0.0001) and 15.1% (p&lt;0.0001) of plagiocephaly and healthy controls, respectively. Among craniosynostosis patients, utilization was not uniform by age; while ophthalmology utilization did not differ by age (p = 0.1003), mental health care was most commonly used among older children (p = 0.0107). CONCLUSION: In this study, we demonstrate that children with craniosynostosis utilize mental health care, rehabilitation therapies, and other medical subspecialty services at a higher rate than controls. While surgical correction may be considered an isolated event, these children should be monitored for developmental and mental health support longitudinally. Future work should explore risk factors driving utilization, including suture involvement, repair type, and comorbidities.