The Use of Mental Health Care Among Mothers of Children With MS

Mothers of children with multiple sclerosis (MS) use more mental health services before and after their child’s MS diagnosis than mothers of children without MS, according to new research.¹

These findings came about after a research team from Canada compared the use of mental health and physical health services among mothers of children with MS and those of children without MS.

Lead researcher Ruth Ann Marrie, MD, PhD, answered our questions about this study and the impact of its findings.

Dr Marrie is a professor of medicine and community health sciences at the Max Rady College of Medicine at the University of Manitoba and is the director of the Multiple Sclerosis Clinic at the Health Sciences Centre in Winnipeg, Manitoba, Canada.

CONSULTANT360: Can you tell us more about how this study came about?

Ruth Ann Marrie: This study grew out of an ongoing study about pediatric demyelinating diseases, including MS, led by Brenda Banwell, MD. That study has followed more than 400 children with a first demyelinating event for up to 10 years. An important finding from that study was that the major determinant of quality of life for these children was the quality of life of their parents. Along with the literature regarding the effects on caregivers of supporting an adult with MS, this led to our interest in better understanding the health of the parents of children with MS.

CONSULTANT360: Among your findings was that mothers of children with MS did not have higher rates of primary care visits but exhibited increased odds of having any psychiatry visits, despite having a higher prevalence of any physical condition or mood disorder. What factors do you think contributed to the higher odds of psychiatry visits? Do you think support groups for mothers of children with MS would be beneficial?

Dr Marrie: Administrative data do not allow us to directly determine why the mothers were more likely to see psychiatrists. However, these findings, along with the higher prevalence of mood disorders suggest a greater burden of mental health issues among mothers of children with MS than among mothers of children without MS. The health system does need to do a better job of identifying parental health concerns and recognizing the role that they play in the health of children. Support groups, whether in person or through online platforms, may be one option to explore in future studies.

CONSULTANT360: These findings, taken together, might suggest that mothers of children with MS may carry the mental burden of their child’s MS diagnosis. How can health care providers reduce this burden for their patients and their patients’ parents/guardians?

Dr Marrie: Several factors may contribute to the impact of the child’s MS diagnosis on the parents, including uncertainty and worry about the child’s future, the additional responsibilities of health care visits and monitoring treatment, and costs, and lack of specific supports for parents in these situations. Additional education and prognostic information may help parents better understand health system navigation issues and reduce worry. Actively identifying parents who are struggling with their mood so that they can get the appropriate access to mental health resources may help. Thinking about specific supports—through the health system or advocacy groups—may also help.

CONSULTANT360: In your opinion, how do you think the price of MS treatment impacts mothers (or guardians) of children with MS? Do you think this contributes to their mental health status?

Dr Marrie: The costs of treatment, lost time from work, and other out-of-pocket costs can add to the stress of chronic illness. We did not evaluate this in our study, so I do not know if it was a contributor here.

CONSULTANT360: What is your overall key take-home message for neurologists and MS specialists today?

Dr Marrie: Health care providers caring for children with MS need to consider the whole family unit as relevant to the child’s outcomes. This means recognizing that parents may need and want additional supports as there is a high burden of mood disorders, and helping them access this care may help parents and their children have better outcomes.

Reference

1. Marrie RA, O’Mahony J, Maxwell C, et al. Increased mental health care use by mothers of children with multiple sclerosis [published online January 9, 2020]. Neurology. https://doi.org/10.1212/WNL.0000000000008871.