Predicting patterns of service utilization within children's mental health agencies.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Child Health Services/*statistics & numerical data ; Facilities and Services Utilization/*statistics & numerical data ; Mental Disorders/*therapy ; Mental Health Services/*statistics & numerical data; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male

Background: Some children with mental health (MH) problems have been found to receive ongoing care, either continuously or episodically. We sought to replicate patterns of MH service use over extended time periods, and test predictors of these patterns.
Methods: Latent class analyses were applied to 4 years of visit data from five MH agencies and nearly 6000 children, 4- to 13-years-old at their first visit.
Results: Five patterns of service use were identified, replicating previous findings. Overall, 14% of cases had two or more episodes of care and 23% were involved for more than 2 years. Most children (53%) were seen for just a few visits within a few months. Two patterns represented cases with two or more episodes of care spanning multiple years. In the two remaining patterns, children tended to have just one episode of care, but the number of sessions and length of involvement varied. Using discriminant function analyses, we were able to predict with just over 50% accuracy children's pattern of service use. Severe externalizing behaviors, high impairment, and high family burden predicted service use patterns with long durations of involvement and frequent visits.
Conclusions: Optimal treatment approaches for children seen for repeated episodes of care or for care lasting multiple years need to be developed. Children with the highest level of need (severe pathology, impairment, and burden) are probably best served by providing high intensity services at the start of care.

J Behav Health Serv Res. 2002 Feb;29(1):45-60. (PMID: 11840904)
Evid Based Ment Health. 2018 Aug;21(3):112-115. (PMID: 29976564)
Ment Health Serv Res. 2004 Dec;6(4):213-26. (PMID: 15588032)
J Child Psychol Psychiatry. 2009 Apr;50(4):416-23. (PMID: 19017368)
Br J Psychiatry. 2005 Jan;186:11-7. (PMID: 15630118)
Early Interv Psychiatry. 2015 Dec;9(6):433-46. (PMID: 25762206)
Child Adolesc Psychiatr Clin N Am. 2014 Jan;23(1):97-110. (PMID: 24231170)
J Behav Health Serv Res. 2010 Jul;37(3):350-62. (PMID: 19277868)
Psychol Serv. 2016 Feb;13(1):77-91. (PMID: 26845491)
Psychiatr Serv. 2010 Aug;61(8):788-95. (PMID: 20675837)
Adm Policy Ment Health. 2010 Sep;37(5):433-45. (PMID: 20063073)
Public Health Rep. 2006 May-Jun;121(3):311-23. (PMID: 16640156)
Autism Res. 2017 Aug;10(8):1436-1447. (PMID: 28383156)
Child Dev. 2000 May-Jun;71(3):802-19. (PMID: 10953944)
Am J Psychiatry. 2002 May;159(5):845-51. (PMID: 11986140)
Behav Ther. 2006 Mar;37(1):36-48. (PMID: 16942959)
Dev Psychopathol. 2016 Nov;28(4pt1):971-986. (PMID: 27739384)
Adm Policy Ment Health. 2011 Sep;38(5):384-97. (PMID: 21057868)
Clin Child Psychol Psychiatry. 2008 Jul;13(3):365-76. (PMID: 18783120)
Child Psychiatry Hum Dev. 2020 Feb;51(1):13-26. (PMID: 31289986)
Am Psychol. 1996 Jul;51(7):689-701. (PMID: 8694389)
J Am Acad Child Adolesc Psychiatry. 2003 Jun;42(6):692-700. (PMID: 12921477)
Psychiatr Serv. 2004 Sep;55(9):1022-8. (PMID: 15345762)
Health Serv Res. 1974 Fall;9(3):208-20. (PMID: 4436074)
J Behav Health Serv Res. 2009 Oct;36(4):492-504. (PMID: 18688725)
Med Care Res Rev. 2014 Jun;71(3):261-79. (PMID: 24399817)
Lancet. 2018 Apr 28;391(10131):1718-1735. (PMID: 29483027)
JAMA. 2002 Oct 16;288(15):1909-14. (PMID: 12377092)
Can J Psychiatry. 2004 Nov;49(11):761-8. (PMID: 15633854)
Milbank Q. 1996;74(4):511-44. (PMID: 8941260)
Adm Policy Ment Health. 2015 Mar;42(2):121-5. (PMID: 24893944)
J Am Acad Child Adolesc Psychiatry. 1998 Nov;37(11):1184-90. (PMID: 9808930)
J Clin Psychol. 2012 Jan;68(1):24-40. (PMID: 21989865)
Psychol Trauma. 2018 Nov;10(6):652-661. (PMID: 29172561)
Adm Policy Ment Health. 2016 May;43(3):297-301. (PMID: 25234345)
Eur Child Adolesc Psychiatry. 2003 Aug;12(4):153-61. (PMID: 14505065)
Acta Psychiatr Scand. 1989 Jan;79(1):1-10. (PMID: 2648766)
Med Care. 1999 Jan;37(1):5-14. (PMID: 10413387)
BMC Health Serv Res. 2019 Dec 23;19(1):993. (PMID: 31870372)
Psychol Med. 2006 Feb;36(2):159-65. (PMID: 16420712)
J Consult Clin Psychol. 2002 Apr;70(2):299-310. (PMID: 11952188)
J Can Acad Child Adolesc Psychiatry. 2010 Aug;19(3):182-96. (PMID: 20842273)
J Child Psychol Psychiatry. 2006 Jul;47(7):649-59. (PMID: 16790000)
Adm Policy Ment Health. 2007 Jul;34(4):353-62. (PMID: 17295060)
Milbank Mem Fund Q Health Soc. 1973 Winter;51(1):95-124. (PMID: 4198894)
J Behav Health Serv Res. 2017 Apr;44(2):316-330. (PMID: 26860728)
Arch Gen Psychiatry. 2012 Mar;69(3):274-82. (PMID: 22065252)
J Am Acad Child Adolesc Psychiatry. 2004 Apr;43(4):440-51. (PMID: 15187804)
Eval Program Plann. 2010 Feb;33(1):59-62. (PMID: 19836078)
J Am Acad Child Adolesc Psychiatry. 2000 Feb;39(2):161-8. (PMID: 10673825)
Psychol Bull. 2017 Feb;143(2):142-186. (PMID: 28004947)
J Can Acad Child Adolesc Psychiatry. 2018 Apr;27(2):88-98. (PMID: 29662520)
Child Adolesc Ment Health. 2014 May;19(2):115-121. (PMID: 32878390)
Clin Psychol Rev. 2013 Jul;33(5):698-711. (PMID: 23742782)
Can Child Adolesc Psychiatr Rev. 2004 Nov;13(4):105-9. (PMID: 19030488)
Health Serv Res. 2005 Oct;40(5 Pt 1):1514-33. (PMID: 16174145)
J Child Psychol Psychiatry. 2008 Sep;49(9):900-14. (PMID: 18573144)
J Autism Dev Disord. 2016 Jul;46(7):2480-9. (PMID: 27084080)
J Consult Clin Psychol. 2015 Dec;83(6):1085-96. (PMID: 26030761)
Adm Policy Ment Health. 2016 May;43(3):325-43. (PMID: 26744316)
J Am Acad Child Adolesc Psychiatry. 2010 Jun;49(6):595-605. (PMID: 20494269)
J Behav Health Serv Res. 1999 May;26(2):185-202. (PMID: 10230146)
J Am Acad Child Adolesc Psychiatry. 2007 Dec;46(12):1605-13. (PMID: 18030082)
Adm Policy Ment Health. 2015 Nov;42(6):737-47. (PMID: 25403258)
J Evid Based Soc Work. 2013;10(4):338-52. (PMID: 23879357)
J Anxiety Disord. 2017 Oct;51:7-13. (PMID: 28843575)
JAMA. 2002 Oct 9;288(14):1775-9. (PMID: 12365965)
Eur Child Adolesc Psychiatry. 2007 Dec;16(8):484-94. (PMID: 17896121)
J Behav Health Serv Res. 2020 Jan;47(1):21-37. (PMID: 31286345)
J Ment Health. 2012 Apr;21(2):165-73. (PMID: 22559827)
J Child Psychol Psychiatry. 2009 Apr;50(4):424-31. (PMID: 19175807)
Pediatrics. 2013 Oct;132(4):e996-e1009. (PMID: 24043282)
Stat Med. 1986 Jan-Feb;5(1):21-7. (PMID: 3961312)
J Behav Health Serv Res. 2015 Jul;42(3):292-309. (PMID: 25813915)
J Clin Psychiatry. 2019 May 7;80(3):. (PMID: 31087826)
Psychiatr Serv. 2006 Jul;57(7):966-75. (PMID: 16816281)

106442 Canada CAPMC CIHR

Keywords: Children; Mental health; Mental health services; Patterns of service use

Date Created: 20191225 Date Completed: 20200327 Latest Revision: 20231027

20240829

PMC6929287

10.1186/s12913-019-4842-2

31870372