Service Costs of Caring for Adolescents With Mental Illness in a Rural Community, 1993–2000
Abstract
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.
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Mental health needs during youth are still largely unmet.
“mental health needs during this critical period are still largely unmet”
From Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? (2020) · cites this paper as [17]
Use of mental health services is modest despite high prevalence of mental health problems among young individuals.
“with a modest use of mental health services despite the high prevalence of mental health problems among young individuals [17]”
From Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? (2020) · cites this paper as [17]
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- Authors
- Costello, E. J., Copeland, W., Cowell, A., & Keeler, G.
- Venue
- American Journal of Psychiatry
- Published
- 2007-01
- Volume
- 164
- Issue
- 1
- Pages
- 36-42
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W4229606410
- Cited by
- 35
- References
- 34
- Citations by year
- 2026: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2018: 3 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 3 · 2013: 1 · 2012: 1
- FWCI
- 7.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- adolescent mental disorders, mental health care costs, unmet mental health needs, juvenile justice, residential treatment, public health insurance, rural communities, comorbidities
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