Estimating prevalence of child and youth mental disorder and mental health-related service contacts: a comparison of survey data and linked administrative health data

Duncan, Laura; Georgiades, Katholiki; Wang, Lulu; Edwards, Jordan; Comeau, Jinette

doi:10.1017/s204579602200018x

Cited by 9 publications

(3 citation statements)

References 39 publications

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“…A strength of this study was the combined register data gathered and merged from several different administrative registers that presented both health care and other service utilization in the population. Compared to survey data, which may suffer from response bias, register-based data is more reliable in terms of missing information and selection into data [ 50 ]. The data also enabled visits in primary and specialized care to be studied separately, which in turn offered a more comprehensive view on the health care utilization trajectories.…”

Section: Discussionmentioning

confidence: 99%

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Association of mental health and behavioral disorders with health care and service utilization in children before and after diagnosis

Nurminen

2022

PLoS ONE

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Mental health is one of the most important contributors to the global burden of disease in children and adolescents. Mental health conditions are associated with lower quality of life in adulthood. These conditions have an early onset and typically first occur in childhood. However, little is known about how these conditions are related to service utilization before the initial diagnosis, or about the significance of the diagnosis on later service utilization. To study this, register data on 5-15-year-old children in the city of Oulu, Finland, covering the years 2013–2018 were used. To identify the association of mental health and behavioral conditions with service utilization, counterfactuals were constructed from children who were similarly diagnosed three years later. Event study regressions on several health care and service utilization outcomes were estimated. The findings showed that primary and specialized health care utilization increased sharply before the initial diagnosis and peaked during the time of diagnosis. Primary care utilization started decreasing slowly after, while specialized health care utilization remained high for two years after the diagnosis. Probability of visiting a mental health professional, use of rehabilitation services, psychiatric medication, and utilization of child protection services increased significantly after the diagnosis. The results highlighted the importance of outpatient health care in detecting and treating the conditions in children. In a fragmented system, knowledge on utilization trajectories in different services may be of help in allocating resources to improve the health of these children.

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Section: Discussionmentioning

confidence: 99%

“…Furthermore, the study population was identified based on the diagnosis. Mental health and behavioral conditions can be underdiagnosed in children to some extent [50][51][52]. Thus, the service utilization of these children could not be studied here.…”

Section: Methodological Considerationsmentioning

confidence: 99%

Association of mental health and behavioral disorders with health care and service utilization in children before and after diagnosis

Nurminen

2022

PLoS ONE

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“…Each visit had an associated indicator column for whether a patient had an ED revisit within the next 30 days. While restricting ED visits and revisits to mental health-related diagnoses was considered, we included any ED visits and revisits for the following reasons: 1) ICD-10 codes (used for most responsible diagnosis) underrepresent child/youth psychiatric disorders; 29 2) diagnostic codes for mental health and substance use disorders used in administrative health records are unreliable; 30,31 3) most responsible diagnosis and presenting complaint misses any secondary mental health-related diagnoses that might be a contributing reason for the visit. Instead, we use EHR data from mental health outpatients expecting that they may be at increased risk for visiting an ED for mental health-related concerns compared to children and youth who did not receive outpatient services during the study timeframe.…”

Section: Datasetmentioning

confidence: 99%

Prediction of Emergency Department Revisits among Child and Youth Mental Health Outpatients Using Deep Learning Techniques

Saggu,

Daneshvar,

Samavi

et al. 2023

Preprint

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Background The proportion of Canadian youth seeking mental health support from an emergency department (ED) has risen in recent years. As EDs typically address urgent mental health crises, revisiting an ED may represent unmet mental health needs. Accurate ED revisit prediction could aid early intervention and ensure efficient healthcare resource allocation. We examine the potential increased accuracy and performance of graph neural network (GNN) machine learning models compared to recurrent neural network (RNN) and a baseline regression models for predicting ED revisit in electronic health record (EHR) data. Methods This study used EHR data for children and youth aged 4–17 seeking services at McMaster Children's Hospital's Child and Youth Mental Health Program outpatient services to develop and evaluate GNN and RNN models to predict whether a child/youth with an ED visit had an ED revisit within 30 days. Candidate GNN and RNN models were developed and the best performing of each model was selected for comparison. Model performance for a GNN, RNN and a logistic regression was evaluated using F1 scores. Results The GNN model outperformed the best performing RNN model by an F1-score increase of 0.0287. Precision, recall, receiver operating characteristic (ROC) curves, and positive and negative predictive values showed that both the RNN and GNN models performed better than the baseline logistic regression model and that performance increases were most noticeable for recall and negative predictive value (59% vs. 66%) than for precision and positive predictive value (62% vs. 66%). Conclusions This study demonstrates the improved accuracy and potential utility of GNN models in predicting ED revisits among children and youth, although model performance may not be sufficient for clinical implementation. Given the improvements in recall and negative predictive value, GNN models should be further explored to develop algorithms that can inform clinical decision-making in ways that facilitate targeted interventions, optimize resource allocation, and improve outcomes for children and youth.

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Childhood conduct problems and adolescent medical service use: serial mediating effects of peer victimization and internalizing problems

Crescenzi,

Martin-Storey,

Poirier

et al. 2024

Psychol. Med.

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Background Adolescents with a history of conduct problems (CP) are at heightened risk of increased service utilization as they develop. While the mechanisms underlying this association are unclear, early CP have also been linked with peer victimization and internalizing problems. The goals of the current study were: (1) to examine peer victimization and internalizing problems as potential serial mediators explaining increased medical and psychiatric service use in adolescents with a history of childhood CP, and; (2) to explore whether the proposed mediation models vary by sex. Methods Participants (N = 744; 53% boys, Mage = 8.39 years) from an ongoing longitudinal study that began in 2008 in Québec, Canada were recruited and assessed for CP, service use, and other behaviours via self-, parent- and teacher-reported questionnaires. Serial mediation analyses were conducted to examine the effects of peer victimization and internalizing problems on the association between childhood CP and adolescent medical and psychiatric service use, controlling for sex and household income. Results Adolescents with childhood CP reported higher medical and psychiatric service use than non-CP peers. Peer victimization and internalizing problems significantly mediated this association in both general medical and psychiatric service use models. The models did not vary by sex. Conclusions Findings support higher levels of service use in adolescents with a history of CP, mediated by peer victimization and internalizing problems. Specifically, results highlight the importance of examining peer and socioemotional factors that may explain the increased service usage observed among youth with CP, to support better health outcomes.

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Estimating prevalence of child and youth mental disorder and mental health-related service contacts: a comparison of survey data and linked administrative health data

Cited by 9 publications

References 39 publications

Association of mental health and behavioral disorders with health care and service utilization in children before and after diagnosis

Association of mental health and behavioral disorders with health care and service utilization in children before and after diagnosis

Prediction of Emergency Department Revisits among Child and Youth Mental Health Outpatients Using Deep Learning Techniques

Childhood conduct problems and adolescent medical service use: serial mediating effects of peer victimization and internalizing problems

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