Long term economic impact of childhood emotional and behavioural problems

Lead Research Organisation: London School of Economics & Pol Sci
Department Name: Personal Social Services Research Unit

Abstract

This study will evaluate the economic impacts in adulthood of mental health problems experienced by children and young people. Mental health problems are common among children and young people and it is known that they can have long lasting effects into adulthood. These effects have economic consequences, both in the short term (e.g., through the costs of health care and educational support) and into adulthood and across the life-span (e.g. service use in adulthood due to continued difficulties, loss of earnings and unemployment).

There is only limited information on the relationship between early difficulties and economic impacts in adulthood. Existing studies only look at short-term impacts, or focus on specific communities or types of mental disorder.

Data from three British birth cohorts will be used, providing detailed information on people born in 1946, 1958 and 1970. Data have been collected from these groups of people from birth throughout their lives, including information on their mental health, use of mental health services, education, employment and income.

These data will be analysed to understand how mental health problems among children and young people are linked to different outcomes during adulthood.

Our study has four parts:

First, we will analyse the economic impacts up to mid and later adulthood associated with childhood mental health problems, by looking at how childhood difficulties are linked to specific events in adulthood (for example, using services for mental health problems, having been in contact with the criminal justice system, a person's level of income, whether they have received benefits) and work out the costs of these outcomes.

Second, we will investigate whether the effects of having a mental health problem early in life influence various economic impacts over the lifespan. At what ages are costs greatest? How do these cost patterns differ among individuals, for example by gender, ethnicity or socioeconomic group? Do some types of mental health problem have higher costs later in life? We will also look at how changes in educational, health and social care policies have influenced costs.

Third, we plan to understand and assess the potential for the long term economic effects of early intervention for mental health problems and the impact needed for early interventions to be cost saving.

Finally, we plan to use the findings from this research as a basis for more detailed studies in the future. By taking into account the new information this research provides about the relationship between childhood difficulties and their economic impact during mid and later adulthood, future studies can investigate these associations in more detail (for example, types of childhood difficulties, costs associated with these over the life course, causal pathways for these costs and benefits of various mental health interventions).

Planned Impact

This would be the first study to use nationally representative samples to estimate the long-term economic impacts up to mid- and later life of a range of mental health problems experienced by children and young people. Through collaboration with the Centre for Mental Health, this work will reach a large number of commissioners, managers and practitioners working in health, social care and other systems, and across public and other sectors. PSSRU and the Centre for Mental Health have longstanding relationships with many key stakeholders, working with them to help interpret and best utilise research evidence. The proposed study will generate new evidence on the long-term impacts of mental health problems which can be disseminated and used to inform discussion about a number of things, including investments in various interventions. In addition to academic publications, the results of this work will be disseminated through a report written in non-academic language. We will plan a launch event for this report with key stakeholder groups, and also make our findings available on the PSSRU and Centre for Mental Health websites, supported via other social media channels.

A key outcome of this project is that the research will lead to the development of a practicable dataset with estimates of costs attached for a wide range of mental health-related outcomes at different points in the life-course and which can be aggregated over both systems and time. This will facilitate further research by our research team and others on the economic consequences of a range of other risk factors and health behaviours assessed among the cohort participants. Development of the methodology and identification of the costs associated with health service use, education, criminal justice, unemployment, and welfare benefits for each of the cohort members requires a substantial amount of effort, but we believe it will lay the groundwork for additional insightful studies. Training of an early career researcher to develop expertise in this area where there is currently a paucity of researchers will also help to facilitate continuation of work in this important area.

By providing information to guide investment in health, social care and other services, the ultimate aim of this work is to improve the support given to young people experiencing mental health problems. We will also work with third sector organisations such as Young Minds and the Early Intervention Foundation to communicate information that can be useful to help young people, their families and others to understand the implications and empower them to advocate for effective mental health care.

Publications

10 25 50