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      The cost of mental and physical health disability in childhood and adolescence to families in the UK: findings from a repeated cross-sectional survey using propensity score matching

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          Abstract

          Objective

          In the UK, families of disabled children are entitled to receive disability benefits to help meet costs associated with caring for their child. Evidence of actual costs incurred is scant, especially for mental health disability. In this study, we aimed to quantify the cost of mental and physical health disability in childhood and adolescence to families in the UK using the concept of compensating variation (CV).

          Design

          Repeated cross-sectional survey.

          Setting

          The UK general population

          Participants

          85 212 children drawn from 8 waves of the Family Resources Survey.

          Outcomes

          Using propensity score matching we matched families with a disabled child to similar families without a disabled child and calculated the extra income the former require to achieve the same living standards as the latter, that is, their CV. We calculated the additional costs specifically associated with several definitions of mental health and physical health disability.

          Results

          Families of a child with any mental health disability, regardless of the presence of physical health comorbidity, needed an additional £49.31 (95% CI: 21.95 to 76.67) and, for more severe disabilities, an additional £57.56 (95% CI: 17.69 to 97.44) per week to achieve the same living standards of families without a disabled child. This difference was greater for more deprived families, who needed between £59.28 (95% CI: 41.38 to 77.18) and £81.26 (95% CI: 53.35 to 109.38) more per week depending on the extent of mental health disability. Families of children with physical health disabilities, with or without mental health disabilities, required an additional £35.86 (95% CI: 13.77 to 57.96) per week, with economically deprived families requiring an extra £42.18 (95% CI: 26.38 to 57.97) per week.

          Conclusions

          Mental and physical health disabilities among children and adolescents were associated with high additional costs for the family, especially for those from deprived economic backgrounds. Means testing could help achieve a more equitable redistribution of disability benefit.

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          Most cited references21

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          Matching As An Econometric Evaluation Estimator

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            Large Sample Properties of Matching Estimators for Average Treatment Effects

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              Is Open Access

              Epidemiology of mental disorders in children and adolescents

              This article provides a review of the magnitude of mental disorders in children and adolescents from recent community surveys across the world. Although there is substantial variation in the results depending upon the methodological characteristics of the studies, the findings converge in demonstrating that approximately one fourth of youth experience a mental disorder during the past year, and about one third across their lifetimes. Anxiety disorders are the most frequent conditions in children, followed by behavior disorders, mood disorders, and substance use disorders. Fewer than half of youth with current mental disorders receive mental health specialty treatment. However, those with the most severe disorders tend to receive mental health services. Current issues that are now being identified in the field of child psychiatric epidemiology include: refinement of classification and assessment, inclusion of young children in epidemiologic surveys, integration of child and adult psychiatric epidemiology, and evaluation of both mental and physical disorders in children.

                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2018
                1 February 2018
                : 8
                : 2
                : e018729
                Affiliations
                [1 ] departmentDivision of Psychiatry , University College London , London, UK
                [2 ] departmentDepartment of Applied Health Research , University College London , London, UK
                Author notes
                [Correspondence to ] Dr Francesca Solmi; francesca.solmi@ 123456ucl.ac.uk
                Author information
                http://orcid.org/0000-0003-0219-9503
                Article
                bmjopen-2017-018729
                10.1136/bmjopen-2017-018729
                5829601
                29391378
                ee882395-6174-48c5-84d8-2d045f91393a
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 17 July 2017
                : 27 October 2017
                : 03 November 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000276, Department of Health;
                Categories
                Mental Health
                Research
                1506
                1712
                Custom metadata
                unlocked

                Medicine
                child disability,living standards,compensating variation,propensity score matching,disability benefits

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