scholarly journals The Persistence of Child and Adolescence Mental Healthcare: Results from Registry Data

2020 ◽  
Author(s):  
Hermien Dijk ◽  
Roel Freriks ◽  
Rob Alessie ◽  
Jochen Mierau
Keyword(s):  
Children And Adolescents ◽  
Mental Healthcare ◽  
Child And Adolescent ◽  
Individual Characteristics ◽  
Registry Data ◽  
Direct Care ◽  
Sudden Increase ◽  
Policy Reforms ◽  
Lagged Dependent Variable ◽  
Time Invariant

Abstract Background: Previous studies on the persistence of child and adolescent mental healthcare do not consider the role of time-invariant individual characteristics. Estimating persistence of healthcare using standard linear models yields biased estimates due to unobserved heterogeneity and the autoregressive structure of the model. This study provides estimates of the persistence of child and adolescent mental healthcare taking these statistical issues into account. Methods: We use registry data of more than 80,000 Dutch children and adolescents between 2000 and 2012 from the Psychiatric Case Registry Northern Netherlands (PCR-NN). In order to account for autocorrelation due to the presence of a lagged dependent variable and to distinguish between persistence caused by time-invariant individual characteristics and a direct care effect we use difference GMM-IV estimation. In further analyses we assess the robustness of our results to policy reforms, different definitions of care and diagnosis decomposition. Results: All estimation results for the direct care effect (true state-dependence) show a positive coefficient smaller than unity with a main effect of 0.215 (p < 0.01), which indicates that the process is stable. Persistence of care is found to be 0.065 (p < 0.05) higher for females. Additionally, the majority of persistence of care appears to be associated with time-invariant characteristics. Further analyses indicate that (1) policy reforms only slightly affected persistence of care, (2) results are robust to different definitions of care and (3) persistence of care does not differ significantly across subgroups. Conclusions: The results indicate that the majority of mental healthcare persistence for children and adolescents is due to time-invariant individuals characteristics. Additionally, we find that in the absence of further shocks a sudden increase of 10 care contacts in the present year is associated with approximately 3 additional care contacts at some point in the future. This result provides essential information about the necessity of budget increases for future years in the case of exogenous increases in healthcare use.

scholarly journals The Persistence of Child and Adolescence Mental Healthcare: Results from Registry Data

2020 ◽  
Author(s):  
Hermien Dijk ◽  
Roel Freriks ◽  
Rob Alessie ◽  
Jochen Mierau
Keyword(s):  
Children And Adolescents ◽  
Mental Healthcare ◽  
Child And Adolescent ◽  
Individual Characteristics ◽  
Registry Data ◽  
Direct Care ◽  
Sudden Increase ◽  
Policy Reforms ◽  
Lagged Dependent Variable ◽  
Time Invariant

Abstract Background: Previous studies on the persistence of child and adolescent mental healthcare do not consider the role of time-invariant individual characteristics. Estimating persistence of healthcare using standard linear models yields biased estimates due to unobserved heterogeneity and the autoregressive structure of the model. This study provides estimates of the persistence of child and adolescent mental healthcare taking these statistical issues into account. Methods: We use registry data of more than 80,000 Dutch children and adolescents between 2000 and 2012 from the Psychiatric Case Registry Northern Netherlands (PCR-NN). In order to account for autocorrelation due to the presence of a lagged dependent variable and to distinguish between persistence caused by time-invariant individual characteristics and a direct care effect we use difference GMM-IV estimation. In further analyses we assess the robustness of our results to policy reforms, different definitions of care and diagnosis decomposition. Results: All estimation results for the direct care effect (true state-dependence) show a positive coefficient smaller than unity with a main effect of 0.215 ( p < 0.01), which indicates that the process is stable. Persistence of care is found to be 0.065 ( p < 0.05) higher for females. Additionally, the majority of persistence of care appears to be associated with time-invariant characteristics. Further analyses indicate that (1) policy reforms only slightly affected persistence of care, (2) results are robust to different definitions of care and (3) persistence of care does not differ significantly across subgroups. Conclusions: The results indicate that the majority of mental healthcare persistence for children and adolescents is due to time-invariant individuals characteristics. Additionally, we find that in the absence of further shocks a sudden increase of 10 care contacts in the present year is associated with approximately 3 additional care contacts at some point in the future. This result provides essential information about the necessity of budget increases for future years in the case of exogenous increases in healthcare use.

scholarly journals The Persistence of Child and Adolescence Mental Healthcare: Results from Registry Data

2019 ◽  
Author(s):  
Hermien Dijk ◽  
Roel Freriks ◽  
Rob Alessie ◽  
Jochen Mierau
Keyword(s):  
Mental Healthcare ◽  
Child And Adolescent ◽  
Individual Characteristics ◽  
Registry Data ◽  
Direct Care ◽  
Sudden Increase ◽  
Policy Reforms ◽  
Lagged Dependent Variable ◽  
Time Invariant

Abstract Background: Previous studies on the persistence of child and adolescent mental healthcare do not consider the role of time-invariant individual characteristics. Estimating persistence of healthcare using standard linear models yields biased estimates due to unobserved heterogeneity and the autoregressive structure of the model. This study provides estimates of the persistence of child and adolescent mental healthcare taking these statistical issues into account. Methods: We use registry data of more than 80,000 Dutch children and adolescents between 2000 and 2012 from the Psychiatric Case Registry Northern Netherlands (PCR-NN). In order to account for autocorrelation due to the presence of a lagged dependent variable and to distinguish between persistence caused by time-invariant individual characteristics and a direct care effect we use Arellano-Bond estimation. In further analyses we assess the robustness of our results to policy reforms, different definitions of care and diagnosis decomposition. Results: All estimation results for the direct care effect (true state-dependence) show a positive coefficient smaller than unity with a main effect of 0.215 ( p < 0.01), which indicates that the process is stable. Persistence of care is found to be 0.065 ( p < 0:05) higher for females. Additionally, the role of time-invariant characteristics in the persistence of care appears to be large. Further analyses indicate that (1) policy reforms only slightly affected persistence of care, (2) results are robust to different definitions of care and (3) persistence of care does not differ significantly across subgroups. Conclusions: The results indicate that a substantial part of persistence is due to time-invariant individuals characteristics. Additionally, we find that in the absence of further shocks a sudden increase of 10 care contacts in the present year is associated with approximately 3 additional care contacts at some point in the future. This result provides essential information about the necessity of budget increases for future years in the case of exogenous increases in healthcare use.

scholarly journals The Persistence of Child and Adolescence Mental Healthcare: Results from Registry Data

2020 ◽  
Author(s):  
Hermien Dijk ◽  
Roel Freriks ◽  
Rob Alessie ◽  
Jochen Mierau
Keyword(s):  
Children And Adolescents ◽  
Mental Healthcare ◽  
Child And Adolescent ◽  
Individual Characteristics ◽  
Registry Data ◽  
Direct Care ◽  
Sudden Increase ◽  
Essential Information ◽  
Lagged Dependent Variable ◽  
Time Invariant

Abstract Background: Previous studies on the persistence of child and adolescent mental healthcare do not consider the role of time-invariant individual characteristics. Estimating persistence of healthcare using standard linear models yields biased estimates due to unobserved heterogeneity and the autoregressive structure of the model. This study provides estimates of the persistence of child and adolescent mental healthcare taking these statistical issues into account. Methods: We use registry data of more than 80,000 Dutch children and adolescents between 2000 and 2012 from the Psychiatric Case Registry Northern Netherlands (PCR-NN). In order to account for autocorrelation due to the presence of a lagged dependent variable and to distinguish between persistence caused by time-invariant individual characteristics and a direct care effect we use difference GMM-IV estimation. In further analyses we assess the robustness of our results to policy reforms, different definitions of care and diagnosis decomposition. Results: All estimation results for the direct care effect (true state-dependence) show a positive coefficient smaller than unity with a main effect of 0.215 (p < 0.01), which indicates that the process is stable. Persistence of care is found to be 0.065 (p < 0.05) higher for females. Additionally, the majority of persistence of care appears to be associated with time-invariant characteristics. Further analyses indicate that (1) results are robust to different definitions of care and (2) persistence of care does not differ significantly across subgroups. Conclusions: The results indicate that the majority of mental healthcare persistence for children and adolescents is due to time-invariant individuals characteristics. Additionally, we find that in the absence of further shocks a sudden increase of 10 care contacts in the present year is associated with an average of less than 3 additional care contacts at some point in the future. This result provides essential information about the necessity of budget increases for future years in the case of exogenous increases in healthcare use.

scholarly journals The persistence of child and adolescence mental healthcare: results from registry data

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hermien H. Dijk ◽  
Roel D. Freriks ◽  
Rob J.M. Alessie ◽  
Jochen O. Mierau
Keyword(s):  
Children And Adolescents ◽  
Mental Healthcare ◽  
Child And Adolescent ◽  
Individual Characteristics ◽  
Registry Data ◽  
Direct Care ◽  
Sudden Increase ◽  
Essential Information ◽  
Lagged Dependent Variable ◽  
Time Invariant

Abstract Background Previous studies on the persistence of child and adolescent mental healthcare do not consider the role of time-invariant individual characteristics. Estimating persistence of healthcare using standard linear models yields biased estimates due to unobserved heterogeneity and the autoregressive structure of the model. This study provides estimates of the persistence of child and adolescent mental healthcare taking these statistical issues into account. Methods We use registry data of more than 80,000 Dutch children and adolescents between 2000 and 2012 from the Psychiatric Case Registry Northern Netherlands (PCR-NN). In order to account for autocorrelation due to the presence of a lagged dependent variable and to distinguish between persistence caused by time-invariant individual characteristics and a direct care effect we use difference GMM-IV estimation. In further analyses we assess the robustness of our results to policy reforms, different definitions of care and diagnosis decomposition. Results All estimation results for the direct care effect (true state-dependence) show a positive coefficient smaller than unity with a main effect of 0.215 (p<0.01), which indicates that the process is stable. Persistence of care is found to be 0.065 (p<0.05) higher for females. Additionally, the majority of persistence of care appears to be associated with time-invariant characteristics. Further analyses indicate that (1) results are robust to different definitions of care and (2) persistence of care does not differ significantly across subgroups. Conclusions The results indicate that the majority of mental healthcare persistence for children and adolescents is due to time-invariant individuals characteristics. Additionally, we find that in the absence of further shocks a sudden increase of 10 care contacts in the present year is associated with an average of less than 3 additional care contacts at some point in the future. This result provides essential information about the necessity of budget increases for future years in the case of exogenous increases in healthcare use.

scholarly journals The Persistence of Child and Adolescence Mental Healthcare: Results from Registry Data

2020 ◽  
Author(s):  
Hermien Dijk ◽  
Roel Freriks ◽  
Rob Alessie ◽  
Jochen Mierau
Keyword(s):  
Children And Adolescents ◽  
Mental Healthcare ◽  
Child And Adolescent ◽  
Individual Characteristics ◽  
Registry Data ◽  
Direct Care ◽  
Sudden Increase ◽  
Essential Information ◽  
Lagged Dependent Variable ◽  
Time Invariant

Abstract Background: Previous studies on the persistence of child and adolescent mental healthcare do not consider the role of time-invariant individual characteristics. Estimating persistence of healthcare using standard linear models yields biased estimates due to unobserved heterogeneity and the autoregressive structure of the model. This study provides estimates of the persistence of child and adolescent mental healthcare taking these statistical issues into account. Methods: We use registry data of more than 80,000 Dutch children and adolescents between 2000 and 2012 from the Psychiatric Case Registry Northern Netherlands (PCR-NN). In order to account for autocorrelation due to the presence of a lagged dependent variable and to distinguish between persistence caused by time-invariant individual characteristics and a direct care effect we use difference GMM-IV estimation. In further analyses we assess the robustness of our results to policy reforms, different definitions of care and diagnosis decomposition. Results: All estimation results for the direct care effect (true state-dependence) show a positive coefficient smaller than unity with a main effect of 0.215 (p < 0.01), which indicates that the process is stable. Persistence of care is found to be 0.065 (p < 0.05) higher for females. Additionally, the majority of persistence of care appears to be associated with time-invariant characteristics. Further analyses indicate that (1) results are robust to different definitions of care and (2) persistence of care does not differ significantly across subgroups. Conclusions: The results indicate that the majority of mental healthcare persistence for children and adolescents is due to time-invariant individuals characteristics. Additionally, we find that in the absence of further shocks a sudden increase of 10 care contacts in the present year is associated with an average of less than 3 additional care contacts at some point in the future. This result provides essential information about the necessity of budget increases for future years in the case of exogenous increases in healthcare use.

scholarly journals The Persistence of Child and Adolescence Mental Healthcare: Results from Registry Data

2020 ◽  
Author(s):  
Hermien Dijk ◽  
Roel Freriks ◽  
Rob Alessie ◽  
Jochen Mierau
Keyword(s):  
Children And Adolescents ◽  
Mental Healthcare ◽  
Child And Adolescent ◽  
Individual Characteristics ◽  
Registry Data ◽  
Direct Care ◽  
Sudden Increase ◽  
Essential Information ◽  
Lagged Dependent Variable ◽  
Time Invariant

Abstract Background: Previous studies on the persistence of child and adolescent mental healthcare do not consider the role of time-invariant individual characteristics. Estimating persistence of healthcare using standard linear models yields biased estimates due to unobserved heterogeneity and the autoregressive structure of the model. This study provides estimates of the persistence of child and adolescent mental healthcare taking these statistical issues into account. Methods: We use registry data of more than 80,000 Dutch children and adolescents between 2000 and 2012 from the Psychiatric Case Registry Northern Netherlands (PCR-NN). In order to account for autocorrelation due to the presence of a lagged dependent variable and to distinguish between persistence caused by time-invariant individual characteristics and a direct care effect we use difference GMM-IV estimation. In further analyses we assess the robustness of our results to policy reforms, different definitions of care and diagnosis decomposition. Results: All estimation results for the direct care effect (true state-dependence) show a positive coefficient smaller than unity with a main effect of 0.215 ( p < 0.01), which indicates that the process is stable. Persistence of care is found to be 0.065 ( p < 0.05) higher for females. Additionally, the majority of persistence of care appears to be associated with time-invariant characteristics. Further analyses indicate that (1) results are robust to different definitions of care and (2) persistence of care does not differ significantly across subgroups. Conclusions: The results indicate that the majority of mental healthcare persistence for children and adolescents is due to time-invariant individuals characteristics. Additionally, we find that in the absence of further shocks a sudden increase of 10 care contacts in the present year is associated with an average of less than 3 additional care contacts at some point in the future. This result provides essential information about the necessity of budget increases for future years in the case of exogenous increases in healthcare use.

scholarly journals Informative value of referral letters from general practice for child and adolescent mental healthcare

2021 ◽  
Author(s):  
S. Aydin ◽  
M. R. Crone ◽  
B. M. Siebelink ◽  
M. E. Numans ◽  
R. R. J. M. Vermeiren ◽  
...  
Keyword(s):  
General Practice ◽  
Nodal Point ◽  
Mental Healthcare ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Discriminative Ability ◽  
Replication Studies ◽  
Attention Deficit Hyperactivity Disorders ◽  
Referral Letters ◽  
Made In

AbstractAlthough referral letters (RLs) form a nodal point in a patient’s care journey, little is known about their informative value in child and adolescent mental healthcare. To determine the informative value of RLs to child and adolescent psychiatry, we conducted a chart review in medical records of minors registered at specialized mental healthcare between January 2015 and December 2017 (The Netherlands). Symptoms indicated in RLs originating from general practice (N = 723) were coded and cross-tabulated with the best estimate clinical classifications made in psychiatry. Results revealed that over half of the minors in the sample were classified in concordance with at least one reason for referral. We found fair to excellent discriminative ability for indications made in RLs concerning the most common psychiatric classifications (95% CI AUC: 60.9–70.6 for anxiety disorders to 90.5–100.0 for eating disorders). Logistic regression analyses suggested no statistically significant effects of gender, age, severity or mental healthcare history, with the exception of age and attention deficit hyperactivity disorders (ADHD), as RLs better predicted ADHD with increasing age (OR = 1.14, 95% CI 1.03–1.27). Contextual problems, such as difficulties studying, problems with parents or being bullied were indicated frequently and associated with classifications in various disorder groups. To conclude, general practitioners’ RLs showed informative value, contrary to common beliefs. Replication studies are needed to reliably incorporate RLs into the diagnostic work-up.

scholarly journals The Impact of COVID-19 School Closure on Child and Adolescent Health: A Rapid Systematic Review

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 415
Author(s):  
Sonia Chaabane ◽  
Sathyanarayanan Doraiswamy ◽  
Karima Chaabna ◽  
Ravinder Mamtani ◽  
Sohaila Cheema
Keyword(s):  
Systematic Review ◽  
Children And Adolescents ◽  
Adolescent Health ◽  
Children With Disabilities ◽  
Child And Adolescent ◽  
Emergency Department Visits ◽  
School Closure ◽  
School Closures ◽  
Child And Adolescent Health ◽  
The Impact

School closures during pandemics raise important concerns for children and adolescents. Our aim is synthesizing available data on the impact of school closure during the coronavirus disease 2019 (COVID-19) pandemic on child and adolescent health globally. We conducted a rapid systematic review by searching PubMed, Embase, and Google Scholar for any study published between January and September 2020. We included a total of ten primary studies. COVID-19-related school closure was associated with a significant decline in the number of hospital admissions and pediatric emergency department visits. However, a number of children and adolescents lost access to school-based healthcare services, special services for children with disabilities, and nutrition programs. A greater risk of widening educational disparities due to lack of support and resources for remote learning were also reported among poorer families and children with disabilities. School closure also contributed to increased anxiety and loneliness in young people and child stress, sadness, frustration, indiscipline, and hyperactivity. The longer the duration of school closure and reduction of daily physical activity, the higher was the predicted increase of Body Mass Index and childhood obesity prevalence. There is a need to identify children and adolescents at higher risk of learning and mental health impairments and support them during school closures.

scholarly journals Creating a ‘reverse’ integrated primary and mental healthcare clinic for those with serious mental illness

2015 ◽  
Vol 17 (05) ◽  
pp. 421-427 ◽  
Author(s):  
Alexandros Maragakis ◽  
Ragavan Siddharthan ◽  
Jill RachBeisel ◽  
Cassandra Snipes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Quality Of Care ◽  
Serious Mental Illness ◽  
Mental Healthcare ◽  
Policy Reforms ◽  
Mental Health Settings ◽  
Primary Care Practitioners

Individuals with serious mental illness (SMI) are more likely to experience preventable medical health issues, such as diabetes, hyperlipidemia, obesity, and cardiovascular disease, than the general population. To further compound this issue, these individuals are less likely to seek preventative medical care. These factors result in higher usage of expensive emergency care, lower quality of care, and lower life expectancy. This manuscript presents literature that examines the health disparities this population experiences, and barriers to accessing primary care. Through the identification of these barriers, we recommend that the field of family medicine work in collaboration with the field of mental health to implement ‘reverse’ integrated care (RIC) systems, and provide primary care services in the mental health settings. By embedding primary care practitioners in mental health settings, where individuals with SMI are more likely to present for treatment, this population may receive treatment for somatic care by experts. This not only would improve the quality of care received by patients, but would also remove the burden of managing complex somatic care from providers trained in mental health. The rationale for this RIC system, as well as training and policy reforms, are discussed.

Approaches to Delivering Child and Adolescent Mental Health Services: The South Australian Experience

1995 ◽  
Vol 29 (2) ◽  
pp. 230-237 ◽  
Author(s):  
Michael Gifford Sawyer ◽  
Robert John Kosky
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Children And Adolescents ◽  
Mental Health Problems ◽  
South Australia ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
The South ◽  
Number Of Children

Approximately 10% of children and adolescents experience mental health problems, however only a small proportion receive specialised help. Identifying approaches which can provide a balanced and effective service for the large number of children and adolescents with problems is currently a major challenge for child and adolescent mental health services in Australia. In South Australia, following a review in 1983, child and adolescent services were reorganised into two separate but closely related services. This paper draws on experience in South Australia over the last decade to identify approaches which can be employed in six key areas that significantly influence the effectiveness of child and adolescent mental health services. The paper also describes the specific features which were included in the South Australian child and adolescent mental health service to address these issues.

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