High Medical Care Costs Revealed for Children with Co-Existing Mental health and Substance Use Disorders

Washington, DC, January 15, 2019 - The American Academy of Child and Adolescent Psychiatry (AACAP), the American Academy of Pediatrics, the Society of Child and Adolescent Psychology, the Society for Developmental and Behavioral Pediatrics, and the Society of Pediatric Psychology jointly commissioned the Milliman Group to analyze a large national database of commercial insurance claims to estimate additional payments associated with co-occurring mental health or substance use disorders in youth with chronic medical conditions. The findings point to potential cost benefits of addressing co-existing mental health and substance use disorders.

The new study published in Academic Pediatrics examines a sample of 6.6 million commercially insured children and young people ages 0-26 years and 5.8 million of their parents. In this group, patients with a chronic medical condition and co-occurring mental health or substance use disorders had annual insurance payments 2.4 times larger than those with a chronic medical condition only. Most of the increase in health care claims reflected medical services rather than mental or behavioral health services. This difference translated to a greater estimated annual expenditure of $8.8 billion. Parents of these children also had total insurance payments 59% higher than parents whose children had only a chronic medical condition.

The much higher total health care costs for both children and their parents suggest the potential benefits from preventing or reducing the impact of mental health and substance use disorders among children with chronic medical conditions.

Integrated or collaborative care, in which mental health problems are diagnosed and treated within the medical setting in collaboration with medical professionals, is widely seen as a way to increase access to mental health services and to intervene earlier before problems become more serious. The degree to which integrated care is adopted across the country depends significantly on financial factors, including whether it saves money, on a per capita basis, compared to the current compartmentalized system. These new data help support the potential of collaborative care as a strategy to improve health care costs. Integrated care approaches may be one of the strategies to prevent or reduce the impact of mental health and substance use disorders in children with chronic medical conditions and their parents.

This project is notable as the first time that all five of these child-serving professional organizations have pooled their resources and expertise on a project of mutual interest.

The link to the study is here or www.sciencedirect.com/science/article/pii/S1876285918307083.

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American Academy of Child and Adolescent Psychiatry
AACAP promotes the healthy development of children, adolescents, and families through advocacy, education, and research. Child and adolescent psychiatrists are the leading physician authority on children's mental health. For more information, please visit www.aacap.org.

American Academy of Pediatrics
The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds.

Society of Clinical Child and Adolescent Psychology, Division 53 of the American Psychological Association
The purpose of Division 53: Society of Clinical Child and Adolescent Psychology is to encourage the development and advancement of clinical child and adolescent psychology through integration of its scientific and professional aspects. The division promotes scientific inquiry, training, professional practice, and public policy in clinical child and adolescent psychology as a means of improving the welfare and mental health of children, youth, and families. In the service of these goals, the division promotes the general objectives of the American Psychological Association. https://sccap53.org.

Society for Developmental and Behavioral Pediatrics
The Society for Developmental and Behavioral Pediatrics was founded in 1982 by a small group of forward-thinking pediatricians and their colleagues. SDBP is now an interprofessional organization dedicated to improving the developmental and behavioral health of children by providing exceptional leadership and promoting research, education, advocacy, and practice. SDBP advocates for an integrated approach to the biological, psychological, social, educational and cultural influences on children, youth, and their families. www.sdbp.org.

Society of Pediatric Psychology
The society aims to promote the health and psychological well-being of children, youth and their families through science and an evidence-based approach to practice, education, training, advocacy and consultation. For more visit www.societyofpediatricpsychology.org/leadership.