Evaluating the Impact of Pediatric Digital Mental Health Care on Caregiver Burnout and Absenteeism: Longitudinal Observational Study

Abstract

Background: Caregivers of children with mental health challenges are at heightened risk for burnout and absenteeism. This strain affects both their well-being and work performance, contributing to widespread workplace issues. Digital mental health interventions (DMHIs) are increasingly used to support pediatric mental health, but their impact on caregiver outcomes remains underexplored.

Objective: This study aimed to explore the associations between caregiver burnout, absenteeism (ie, missing work), comorbid symptoms, and child mental health problems, and to assess whether caregiver burnout and absenteeism improved as their child participated in a pediatric DMHI.

Methods: This retrospective study included 6506 caregivers whose children (aged 1-17 years) received care from Bend Health, Inc, a pediatric DMHI providing digital-based therapy and coaching, digital content, and caregiver support. Caregiver burnout, absenteeism, comorbid symptoms, and child mental health symptoms were measured by monthly assessments. Cumulative link models were used to assess the associations of between child symptoms and caregiver outcomes and to assess changes in caregiver outcomes over the course of the DMHI. Analyses of baseline associations included the full sample (n=6506), while analyses of pre-post changes in caregiver outcomes were conducted in caregivers with elevated burnout (n=2121) and absenteeism (n=1327) who had an assessment after starting care.

Results: At baseline, 45.96% (2990/6506) of caregivers reported elevated burnout and 28.96% (1884/6506) reported elevated absenteeism. More severe burnout was associated with having a child with elevated symptoms of any type (all P<.01). More severe absenteeism was significantly associated with having a child with elevated symptoms of depression (z=3.33; P<.001), anxiety (z=3.96; P<.001), inattention (z=2.48; P=.013), and hyperactivity (z=2.12; P=.03). Burnout decreased for 68.64% (1456/2121) and absenteeism decreased for 87.26% (1158/ 1327). Greater months in care was associated with less severe caregiver burnout (z=-5.48; P<.001) and absenteeism (z=-6.74; P<.001).

Conclusions: DMHIs for children may reduce caregiver burnout and absenteeism. These findings emphasize the value of employers offering pediatric DMHIs as part of employee benefits, potentially enhancing workplace outcomes.

Keywords: adolescence; adolescents; child behavior; child behavioral health; children; digital; digital health; digital interventions; digital mental health intervention; digital technology; mental disorders; mental health; mental illnesses; pediatrics; teenagers; workplace outcomes; youth.

Figure 1.. Burnout symptom severity for caregivers with elevated burnout at baseline and a follow-up assessment (n=2121) reported for the baseline and last follow-up assessments.

Figure 2.. Amount of work missed for caregivers with elevated absenteeism at baseline and a follow-up assessment (n=1327) reported for the baseline and last follow-up assessments.