Children with Complex Mental Health Problems: Needs, Costs and Predictors over One Year

Area of Science:

• Child and Adolescent Psychiatry
• Mental Health Services Research
• Developmental Psychology

Background:

• Limited understanding exists regarding the characteristics and service needs of children with complex mental health problems.
• Identifying children most at risk is crucial for targeted interventions and resource allocation.

Purpose of the Study:

• To prospectively investigate the psychiatric diagnoses, psychosocial functioning, needs, and service utilization of 60 children identified as most concerning.
• To determine the associated costs of services for this high-need population over a one-year period.

Main Methods:

• A one-year prospective cohort study design was employed.
• Data collection included psychiatric diagnoses, psychosocial functioning assessments, need status evaluations, and service receipt records for 60 children.
• Cost analysis was conducted based on weekly service expenditures.

Main Results:

• Over half (53%) of the children presented with two or more psychiatric disorders.
• The average number of identified needs per child remained consistent over the study year, though individual variation was significant.
• Mean weekly service costs were substantial (£1017), with higher costs associated with social factors rather than specific diagnoses or needs.

Conclusions:

• Children with complex mental health problems incur significantly higher service costs, approximately ten times those reported in studies of children with less complex mental health needs.
• Social factors appear to be a stronger driver of service costs than diagnostic complexity or the number of needs.
• Further research is needed to understand and address the drivers of high service costs in this vulnerable population.