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Service costs of caring for adolescents with mental illness in a rural community, 1993-2000.

Publication ,  Journal Article
Costello, EJ; Copeland, W; Cowell, A; Keeler, G
Published in: Am J Psychiatry
January 2007

OBJECTIVE: Costs of treating child psychiatric disorders fall on educational, primary care, juvenile justice, and social service agencies as well as on psychiatric services. The authors estimated multiagency mental health costs by integrating service unit costs with utilization rates in an 11-county area. Using psychiatric diagnoses made independently of service use records, the authors calculated costs across agencies as well as the extent of unmet need for psychiatric care. METHOD: Annual parent and child reports were used to measure mental health care needs and units of service across 21 types of settings for the population-based Great Smoky Mountain Study sample of 1,420 adolescents from ages 13 to 16. Unit costs for services were generated from information from service providers and records. The authors calculated costs overall, costs by type of service, and costs by diagnosis. RESULTS: Average annual costs per adolescent treated were $3,146. Juvenile justice and inpatient/residential facilities accounted for well over half of the total costs. Costs for youths with two or more diagnoses were twice as much as costs of those with a single disorder. Among adolescents with service needs, 66.9% received no services. Public health insurance was associated with higher rates of specialty mental health care than either private insurance or no insurance. CONCLUSIONS: Annual costs across all services were three to four times greater than recent health insurance estimates alone. Many costs for adolescents with mental health problems were borne by agencies not designed primarily to provide psychiatric or psychological services. Only one in three adolescents needing psychiatric care received any mental health services.

Duke Scholars

Published In

Am J Psychiatry

DOI

ISSN

0002-953X

Publication Date

January 2007

Volume

164

Issue

1

Start / End Page

36 / 42

Location

United States

Related Subject Headings

  • Social Work, Psychiatric
  • Rural Health Services
  • Psychiatry
  • North Carolina
  • Needs Assessment
  • Mental Disorders
  • Male
  • Insurance, Health
  • Humans
  • Health Services Needs and Demand
 

Citation

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Chicago
ICMJE
MLA
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Costello, E. J., Copeland, W., Cowell, A., & Keeler, G. (2007). Service costs of caring for adolescents with mental illness in a rural community, 1993-2000. Am J Psychiatry, 164(1), 36–42. https://doi.org/10.1176/appi.ajp.2007.164.9.A36
Costello, E Jane, William Copeland, Alexander Cowell, and Gordon Keeler. “Service costs of caring for adolescents with mental illness in a rural community, 1993-2000.Am J Psychiatry 164, no. 1 (January 2007): 36–42. https://doi.org/10.1176/appi.ajp.2007.164.9.A36.
Costello EJ, Copeland W, Cowell A, Keeler G. Service costs of caring for adolescents with mental illness in a rural community, 1993-2000. Am J Psychiatry. 2007 Jan;164(1):36–42.
Costello, E. Jane, et al. “Service costs of caring for adolescents with mental illness in a rural community, 1993-2000.Am J Psychiatry, vol. 164, no. 1, Jan. 2007, pp. 36–42. Pubmed, doi:10.1176/appi.ajp.2007.164.9.A36.
Costello EJ, Copeland W, Cowell A, Keeler G. Service costs of caring for adolescents with mental illness in a rural community, 1993-2000. Am J Psychiatry. 2007 Jan;164(1):36–42.
Journal cover image

Published In

Am J Psychiatry

DOI

ISSN

0002-953X

Publication Date

January 2007

Volume

164

Issue

1

Start / End Page

36 / 42

Location

United States

Related Subject Headings

  • Social Work, Psychiatric
  • Rural Health Services
  • Psychiatry
  • North Carolina
  • Needs Assessment
  • Mental Disorders
  • Male
  • Insurance, Health
  • Humans
  • Health Services Needs and Demand