Identifying attributes of care that may improve cost-effectiveness in the youth mental health service system.
OBJECTIVE
To identify attributes of youth mental health care for which there is evidence of potential cost-effectiveness.


STUDY DESIGN
We performed a literature review of economic evaluations that examined both costs and outcomes for attributes of youth mental health care other than pharmacological or individual psychological therapies for full-threshold disorders.


DATA SOURCES
We searched the United Kingdom National Health Service Economic Evaluations Database for evaluations published to the end of 2014; and MEDLINE, Google Scholar and the citation lists of relevant publications for peer-reviewed studies published in English since 1997.


DATA SYNTHESIS
Forty economic evaluations met inclusion criteria. Psychosis was the mental disorder with the most developed economic evidence base, with good evidence of cost-effectiveness for first-episode psychosis services. There was a developing cost-effectiveness evidence base for other disorders. The most common attributes of the interventions examined in the included studies were the location of services, engagement and support of families, assessment, prevention, early intervention, group delivery format and information provision. We used our findings to formulate a list of attributes of youth mental health care that may be acceptable to young people and potentially cost-effective.


CONCLUSION
There is at least suggestive cost-effectiveness evidence for a range of attributes of youth mental health care. Further economic research is needed to substantiate most cost-effectiveness findings and to improve targeting of care among young people. Future economic evaluations should examine costs from both societal and health care perspectives and incorporate evidence regarding young people's preferences.
['Hamilton|Matthew P|MP|', 'Hetrick|Sarah E|SE|', 'Mihalopoulos|Cathrine|C|', 'Baker|David|D|', 'Browne|Vivienne|V|', 'Chanen|Andrew M|AM|', 'Pennell|Kerryn|K|', 'Purcell|Rosemary|R|', 'Stavely|Heather|H|', 'McGorry|Patrick D|PD|']
D000293:Adolescent D003362:Cost-Benefit Analysis D061345:Early Medical Intervention D005190:Family D006801:Humans D001523:Mental Disorders D008605:Mental Health Services D010353:Patient Education as Topic D010358:Patient Participation D011618:Psychotic Disorders D055815:Young Adult
Mental health services Adolescent medicine Economics, medical Mental health policy