Costs of health and social services use in children of parents with mental illness

Abstract

Background Children of parents with mental illness have a higher risk of developing mental health problems when compared with the general population. Therefore, families with parents with mental illness are a suitable target group for selective prevention. In order to plan and evaluate the health economic consequences of preventive interventions for this target group, data on the societal costs related to parenthood under the condition of mental disorders are needed. To date, within Germany there has been a lack of research evaluating the costs of mental health treatment and use of social services by children and adolescents with parents with mental illness. Methods As part of a multicentre randomised controlled trial, use and costs of health and social services were assessed for a sample of 332 children and adolescents with parents with mental illness in six regions of Germany. Service use at baseline was assessed by the German version of the Children and Adolescent Mental Health Service Receipt Inventory. Costs were calculated for 12 months based on diagnosis and service user status and described separately. Cost drivers were identified by means of a two-part regression model. Results Total mean costs for 12 months for the total sample amount of € 3736.35 (95% CI: € 2816.84–4813.83) per person. Children with a psychiatric diagnosis generated a total of € 5691.93 (95% CI: € 4146.27–7451.38) of costs per person, compared to € 1245.01 (95% CI: € 657.44–1871.49) for children without a psychiatric diagnosis. The logit part indicates significant odds ratios for individual functioning and diagnosis of the child as well as for family functioning. The linear part reveals that increasing individual functioning in the child is related to decreasing costs. Conclusions Children of families with parents with mental illness use a broad spectrum of mental health care, school-based support and youth welfare services even if they are not yet diagnosed as having a mental disorder. Further research should examine whether these institutions are sufficiently qualified and interlinked to meet the support needs of this vulnerable group. Trial registration The study was registered at the 07/10/2014 before the start of data collection (04/11/2014) at the German clinical trials register (Deutsches Register Klinischer Studien, DRKS, nr: DRKS00006806, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00006806).

A Scoping Review of Interventions Designed to Support Parents With Mental Illness That Would Be Appropriate for Parents With Psychosis

“…Children of parents with any kind of mental health diagnosis are more likely than children without parental mental illness to exhibit internalizing and externalizing problems ( 16 ) and are at risk of developing a mental health problem ( 120 , 121 ). While, in theory, enhancing parenting skills should improve the child's quality of life and later psychosocial health ( 122 ), it is nevertheless still important to assess changes in children's functioning following such intervention. The RCT with the longest follow-up in this review was Preventative Basic Care Management ( 85 ), and did not report any difference in child behavior between the intervention and control group after 18 months of intervention.…”

Excess healthcare costs of mental disorders in children, adolescents and young adults in the Basque population registry adjusted for socioeconomic status and sex

“…As suggested by the literature, a possible justification can be that the presence of a mental disorder was associated with an increased risk of subsequent medical conditions [ 49 ]. Different studies also indicate that parental coping with a mental illness is related to the mental health of their children [ 50 – 52 ], as well as with the increase in their healthcare services use [ 53 , 54 ]. However, it must be taken into account that people with mental health disorders are a heterogeneous group with different health and social needs, where the drivers of their higher resource use are likely to be multifactorial [ 48 ].…”

Evaluation of “Cognitive Behavioral Intervention for Trauma in Schools” (CBITS) in child welfare programs in Germany: Study Protocol of a Randomized Controlled Trial

“…The "Child and Adolescent Mental Health Service Receipt Inventory" (CAMHSRI-DE) [23] is a questionnaire for evaluating the use of medical, psychosocial and child welfare services, which consists of 8 parts assessing the number of additional treatments and medication for the previous months.…”