Treatment retention among children entering a new episode of mental health care.
OBJECTIVE
This study examined use of mental health services among children and adolescents with private insurance who were entering treatment. Variations in service use were examined by age, gender, diagnosis, recent psychiatric hospitalization, and type of insurance. Differences between children who received treatment from mental health professionals and those who were treated by primary care physicians were also examined.


METHODS
Drawn from a large database, the sample comprised 11,659 new users of mental health services. Service use was defined as the total number of days children were retained in treatment and the total number of mental health contacts recorded.


RESULTS
The overall mean number of visits within a six-month period was 3.9. The average duration of treatment was 75.36 days. Children who were treated by a mental health specialist were less likely to drop out of treatment and had a larger number of visits. Severity of illness, psychiatric hospitalization, and managed care insurance coverage were also associated with lower risk of dropout and greater intensity of care.


CONCLUSIONS
Children's access to services does not guarantee sustained involvement in treatment. To more fully address the nature of service use among children, a closer look at specific barriers to continued involvement in services is needed.
Harpaz-Rotem
Ilan
I
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06519, USA. ilan.harpaz-rotem@yale.edu
Leslie
Douglas
D
Rosenheck
Robert A
RA
D000293:Adolescent; D002648:Child; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health; D038801:International Classification of Diseases; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000534:rehabilitation / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013997:Time Factors