Utilisation and costs of mental health-related service use among adolescents

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Ziebold, Carolina ; Silva-Ribeiro, Wagner ; King, Derek ; McDaid, David ; Hoffmann, Mauricio Scopel ; Romeo, Renee ; Pan, Pedro Mario ; Miguel, Euripedes Constantino ; Bressan, Rodrigo Affonseca ; Rohde, Luis Augusto ; Salum, Giovanni Abrahao ; Mari, Jair de Jesus ; Evans-Lacko, Sara

• Document type: Journal article
• Source: PLoS One; v. 17, n. 9, p. 17-pg., 2022-09-09.

Abstract

Background The high level of care needs for adolescents with mental health conditions represents a challenge to the public sector, especially in low and middle-income countries. We estimated the costs to the public purse of health, education, criminal justice and social care service use associated with psychiatric conditions among adolescents in Brazil; and examined whether the trajectory of psychopathology and its impact on daily life, and parental stigma towards mental illness, was associated with service utilisation and costs. Methods Data on reported service use among adolescents from a prospective community cohort (n = 1,400) were combined with Brazilian unit costs. Logistic regression and generalised linear models were used to examine factors associated with service use and associated costs, respectively. Results Twenty-two percent of those who presented with a psychiatric disorder used some type of service for their mental health in the previous twelve months. Higher odds of service use were associated with having a diagnosed mental disorder (either incident, [OR = 2.49, 95% CI = 1.44-4.30, p = 0.001], remittent [OR = 2.16, 95%CI = 1.27-3.69, p = 0.005] or persistent [OR = 3.01, 95%CI = 1.69-5.36, p<0.001]), higher impact of symptoms on adolescent's life (OR = 1.32, 95%CI = 1.19-1.47, p<0.001) and lower parental stigma toward mental illness (OR = 1.12, 95%CI = 1.05-1.20, p = 0.001). Average annual cost of service use was 527.14 USD (s.d. = 908.10). Higher cost was associated with higher disorder impact (beta = 0.25, 95%CI = 0.12-0.39, p<0.001), lower parental stigma (beta = 0.12, 95%CI = 0.02-0.23, p = 0.020) and white ethnicity (beta = 0.55, 95%CI = 0.04-1.07, p = 0.036). Conclusion The impact of mental health problems on adolescents' daily lives and parental stigmatising attitudes toward mental illness were the main predictors of both service use and costs. (AU)

• FAPESP's process: 19/08731-0 - Service use among children and adolescents with mental health problems: Costs, predictors and outcomes - A longitudinal study
• Grantee: Carolina Andrea Ziebold Jorquera
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• FAPESP's process: 08/57896-8 - National Institute for Developmental Psychiatry
• Grantee: Eurípedes Constantino Miguel Filho
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 14/50917-0 - INCT 2014: developmental psychiatry for children and adolescents
• Grantee: Eurípedes Constantino Miguel Filho
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 18/05586-7 - Evaluation of the validity and reliability of the diagnostic categories of the primary care version of the eleventh revision of the international classification of diseases: ICD-11 PHC
• Grantee: Carolina Andrea Ziebold Jorquera
• Support Opportunities: Scholarships in Brazil - Doctorate