title: Randomised comparison of the effectiveness and costs of community and hospital based mental health services for children with behavioural disorders.
abstract: OBJECTIVE
  To test the hypothesis that a community based intervention by secondary child and adolescent mental health services would be significantly more effective and less costly than a hospital based intervention.
  
  
  METHODS
  Open study with two randomised parallel groups.
  
  
  METHODS
  Two health districts in the north of England.
  
  
  METHODS
  Parents of 3 to 10 year old children with behavioural disorder who had been referred to child and adolescent mental health services.
  
  
  METHODS
  Parental education groups.
  
  
  METHODS
  Parents' and teachers' reports of the child's behaviour, parental depression, parental criticism of the child, impact of the child's behaviour on the family.
  
  
  RESULTS
  141 subjects were randomised to community (n=72) or hospital (n=69) treatment. Primary outcome data were obtained on 115 (82%) cases a year later. Intention to treat analyses showed no significant differences between the community and hospital based groups on any of the outcome measures, or on costs. Parental depression was common and predicted the child's outcome.
  
  
  CONCLUSIONS
  Location of child mental health services may be less important than the range of services that they provide, which should include effective treatment for parents' mental health problems.
authors.affiliation: Department of Child and Adolescent Psychiatry, University of Manchester, Manchester M27 4HA, UK. R.C.Harrington@man.ac.uk
authors.forename: R
authors.initials: R
authors.lastname: Harrington
authors.forename: S
authors.initials: S
authors.lastname: Peters
authors.forename: J
authors.initials: J
authors.lastname: Green
authors.forename: S
authors.initials: S
authors.lastname: Byford
authors.forename: J
authors.initials: J
authors.lastname: Woods
authors.forename: R
authors.initials: R
authors.lastname: McGowan
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000191:economics / Q000628:therapy*; D002662:Child Health Services / Q000191:economics* / Q000592:standards; D002675:Child, Preschool; D003156:Community Mental Health Services / Q000191:economics* / Q000592:standards; D003365:Costs and Cost Analysis; D004739:England; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology; D016896:Treatment Outcome