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J Child Psychol Psychiatry. 2015 Jun;56(6):667-76. doi: 10.1111/jcpp.12327. Epub 2014 Sep 29.

How do child and adolescent mental health problems influence public sector costs? Interindividual variations in a nationally representative British sample.

Author information

1
Personal Social Services Research Unit, London School of Economics and Political Science, London, UK.
2
Centre for the Economics of Physical and Mental Health, Institute of Psychiatry, King's College London, London, UK.
3
Croydon Adolescent Mental Health Team, London, UK.
4
Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK.
5
Department of Health Sciences, University of Leicester, Leicester, UK.
6
Institute of Health Research, University of Exeter Medical School, Exeter, UK.

Abstract

BACKGROUND:

Policy and practice guidelines emphasize that responses to children and young people with poor mental health should be tailored to needs, but little is known about the impact on costs. We investigated variations in service-related public sector costs for a nationally representative sample of children in Britain, focusing on the impact of mental health problems.

METHODS:

Analysis of service uses data and associated costs for 2461 children aged 5-15 from the British Child and Adolescent Mental Health Surveys. Multivariate statistical analyses, including two-part models, examined factors potentially associated with interindividual differences in service use related to emotional or behavioural problems and cost. We categorized service use into primary care, specialist mental health services, frontline education, special education and social care.

RESULTS:

Marked interindividual variations in utilization and costs were observed. Impairment, reading attainment, child age, gender and ethnicity, maternal age, parental anxiety and depression, social class, family size and functioning were significantly associated with utilization and/or costs.

CONCLUSIONS:

Unexplained variation in costs could indicate poor targeting, inequality and inefficiency in the way that mental health, education and social care systems respond to emotional and behavioural problems.

KEYWORDS:

Psychiatric practice; economic evaluation; education; social work

PMID:
25265159
DOI:
10.1111/jcpp.12327
[Indexed for MEDLINE]

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