TY - JOUR
T1 - Utilisation and costs of mental health-related service use among adolescents
AU - Ziebold, Carolina
AU - Silva-Ribeiro, Wagner
AU - King, Derek
AU - McDaid, David
AU - Hoffmann, Mauricio Scopel
AU - Romeo, Renee
AU - Pan, Pedro Mario
AU - Miguel, Eurípedes Constantino
AU - Bressan, Rodrigo Affonseca
AU - Rohde, Luis Augusto
AU - Salum, Giovanni Abrahão
AU - de Jesus Mari, Jair
AU - Evans-Lacko, Sara
N1 - Funding Information:
Funding:Theresearchpresentedinthisarticlewas fundedbytheEuropeanResearchCouncilunder theEuropeanUnion’sSeventhFramework Programme(FP7/2007-2013)/ERCgrant agreementno337673,andsupportedbytheUK MedicalResearchCouncil(MR/R022763/1), NationalInstituteofDevelopmentalPsychiatryfor ChildrenandAdolescents,ascienceand technologyinstitutefundedbyConselhoNacional de Desenvolvimento Cientı ´ fico e Tecnolo ´gico (CNPq;NationalCouncilforScientificand TechnologicalDevelopment;grantnumbers 573974/2008-0and465550/2014-2)and Fundac ¸aõ deAmparoàPesquisadoEstadodeSaõ Paulo(FAPESPgrantnumber2008/57896-8and 2014/50917-0).SELreceivessupportfromtheUK MedicalResearchCouncilinrelationtothe Mentalkit-Brazilproject(MR/R022763/1)andthe EconomicandSocialResearchCouncil.CZ receivedadoctoralscholarshipandresearch abroadscholarshipbytheFundac ¸ãodeAmparoà PesquisadoEstadodeSãoPaulo(grantnumber 2018/05586-7and2019/08731-0).MSHwas supportedbytheNewtonInternationalFellowship (Ref:NIF\R1\181942),awardedbytheAcademyof MedicalSciencesthroughtheUKGovernment’s NewtonFundProgramme.Thefunding organisationshadnoroleinthestudydesign; collection,analysisorinterpretationofdata;inthe writingofthisarticle;orinthedecisiontosubmit thearticleforpublication.
Publisher Copyright:
© 2022 Ziebold et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2022/9
Y1 - 2022/9
N2 - Background The high level of care needs for adolescents with mental health conditions represents a challenge to the public sector, especially in low and middle-income countries. We estimated the costs to the public purse of health, education, criminal justice and social care service use associated with psychiatric conditions among adolescents in Brazil; and examined whether the trajectory of psychopathology and its impact on daily life, and parental stigma towards mental illness, was associated with service utilisation and costs. Methods Data on reported service use among adolescents from a prospective community cohort (n = 1,400) were combined with Brazilian unit costs. Logistic regression and generalised linear models were used to examine factors associated with service use and associated costs, respectively. Results Twenty-two percent of those who presented with a psychiatric disorder used some type of service for their mental health in the previous twelve months. Higher odds of service use were associated with having a diagnosed mental disorder (either incident, [OR = 2.49, 95% CI = 1.44-4.30, p = 0.001], remittent [OR = 2.16, 95%CI = 1.27-3.69, p = 0.005] or persistent [OR = 3.01, 95%CI = 1.69-5.36, p<0.001]), higher impact of symptoms on adolescent's life (OR = 1.32, 95%CI = 1.19-1.47, p<0.001) and lower parental stigma toward mental illness (OR = 1.12, 95%CI = 1.05-1.20, p = 0.001). Average annual cost of service use was 527.14 USD (s.d. = 908.10). Higher cost was associated with higher disorder impact (β = 0.25, 95%CI = 0.12-0.39, p<0.001), lower parental stigma (β = 0.12, 95%CI = 0.02-0.23, p = 0.020) and white ethnicity (β = 0.55, 95%CI = 0.04-1.07, p = 0.036). Conclusion The impact of mental health problems on adolescents' daily lives and parental stigmatising attitudes toward mental illness were the main predictors of both service use and costs.
AB - Background The high level of care needs for adolescents with mental health conditions represents a challenge to the public sector, especially in low and middle-income countries. We estimated the costs to the public purse of health, education, criminal justice and social care service use associated with psychiatric conditions among adolescents in Brazil; and examined whether the trajectory of psychopathology and its impact on daily life, and parental stigma towards mental illness, was associated with service utilisation and costs. Methods Data on reported service use among adolescents from a prospective community cohort (n = 1,400) were combined with Brazilian unit costs. Logistic regression and generalised linear models were used to examine factors associated with service use and associated costs, respectively. Results Twenty-two percent of those who presented with a psychiatric disorder used some type of service for their mental health in the previous twelve months. Higher odds of service use were associated with having a diagnosed mental disorder (either incident, [OR = 2.49, 95% CI = 1.44-4.30, p = 0.001], remittent [OR = 2.16, 95%CI = 1.27-3.69, p = 0.005] or persistent [OR = 3.01, 95%CI = 1.69-5.36, p<0.001]), higher impact of symptoms on adolescent's life (OR = 1.32, 95%CI = 1.19-1.47, p<0.001) and lower parental stigma toward mental illness (OR = 1.12, 95%CI = 1.05-1.20, p = 0.001). Average annual cost of service use was 527.14 USD (s.d. = 908.10). Higher cost was associated with higher disorder impact (β = 0.25, 95%CI = 0.12-0.39, p<0.001), lower parental stigma (β = 0.12, 95%CI = 0.02-0.23, p = 0.020) and white ethnicity (β = 0.55, 95%CI = 0.04-1.07, p = 0.036). Conclusion The impact of mental health problems on adolescents' daily lives and parental stigmatising attitudes toward mental illness were the main predictors of both service use and costs.
UR - http://www.scopus.com/inward/record.url?scp=85137691811&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0273628
DO - 10.1371/journal.pone.0273628
M3 - Article
C2 - 36084089
AN - SCOPUS:85137691811
SN - 1932-6203
VL - 17
JO - PL o S One
JF - PL o S One
IS - 9 September
M1 - e0273628
ER -
