Economic evaluations of child and adolescent mental health interventions : a systematic review

BACKGROUND : The need has grown over recent years for economic information on the impacts of child and adolescent mental helath problems and the cost-effectiveness of interventions. METHODS : A range of electronic databases were searched using a predefined search strategy. To identify economic studies which focused on services, pharmacological interventions and other treatments for children and adolescents with a diagnosed mental health problem or identified as at risk of mental illness. Published studies were included in the review if they assessed both costs and outcomes, with cost-effectiveness being the primary interest. Articles meeting the criteria for inclusion were assessed for quality. RESULTS : Behavioural disorders have been given relatively large attention in economic evaluations of child and adolescent mental health. These studies tentatively suggest child behavioural gains and parent satisfaction from parent and child training programmes, however the cost effectiveness of the location of delivery for behvaioural therapies is less clear. In general the quality of economic evaluations was limited by small sample sizes, a narrow conceptualisation of costs, narrow perspectives and limited statistical and econometric methods. CONCLUSIONS : Economic evaluations in the field of child and adolescent mental health services are few in number and generally poor in quality, although the number of studies being undertaken is now rising relatively quickly.