Long-term Mental Health Effects of a Pediatric Home Care Program

The increased survival of youngsters with chronic physical disorders has led to concern about their long-term psychological adjustment. Few data are available on how to reduce the psychological morbidity that occurs in the presence of chronic childhood illness. An earlier report of a randomized controlled trial of a pediatric home care program demonstrated that this program, combining comprehensive biomedical and psychosocial care, reduced the short-term psychological morbidity of those receiving home care. However, data have not previously been available on whether the short-term improvement in adjustment is associated with any long-term benefits. This report presents long-term follow-up data collected 4 1/2 to 5 years after enrollment on 68% of the original sample. After this interval there were even larger differences between the experimental and control groups than those previously observed at 6 months and 1 year. This finding provides strong evidence that a comprehensive family-oriented outreach program for youngsters with chronic physical disorders can have long-term mental health benefits. It should encourage clinicians to develop similar programs and investigators to look for long-term effects of other interventions.