Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-09T12:40:36.401Z Has data issue: false hasContentIssue false

Cost-effectiveness analysis of a home-based social work intervention for children and adolescents who have deliberately poisoned themselves

Results of a randomised controlled trial

Published online by Cambridge University Press:  02 January 2018

Sarah Byford*
Affiliation:
Centre for Health Economics, University of York
Richard Harrington
Affiliation:
Department of Child and Adolescent Psychiatry, Royal Manchester Children's Hospital, Manchester
David Torgerson
Affiliation:
Centre for Health Economics, University of York
Michael Kerfoot
Affiliation:
School of Psychiatry and Behavioural Sciences, Mathematics Building, University of Manchester, Manchester
Elizabeth Dyer
Affiliation:
Central Manchester Health Care Trust, Department of Child and Family Psychiatry, The Winnicott Centre, Manchester
Val Harrington
Affiliation:
School of Psychiatry and Behavioural Sciences, Mathematics Building, University of Manchester, Manchester
Adrine Woodham
Affiliation:
School of Psychiatry and Behavioural Sciences, Mathematics Building, University of Manchester, Manchester
Julia Gill
Affiliation:
School of Psychiatry and Behavioural Sciences, Mathematics Building, University of Manchester, Manchester
Faye McNiven
Affiliation:
School of Psychiatry and Behavioural Sciences, Mathematics Building, University of Manchester, Manchester
*
Sarah Byford, Centre for Health Economics, University of York, York YOI 5DD. Fax: 01904 433644; e-mail: [email protected]

Abstract

Background

Little evidence exists regarding the effectiveness or cost-effectiveness of alternative treatment services in the field of child and adolescent psychiatry.

Aims

To assess the cost-effectiveness of a home-based social work intervention for young people who have deliberately poisoned themselves.

Method

Children aged ⩽16 years, referred to child mental health teams with a diagnosis of deliberate self-poisoning were randomly allocated to either routine care (n=77) or routine care plus the social work intervention (n=85). Clinical and resource-use data were assessed over six months from the date of trial entry.

Results

No significant differences were found between the two groups in terms of the main outcome measures or costs. In a sub-group of children without major depression, suicidal ideation was significantly lower in the intervention group at the six-month follow-up (P=0.01), with no significant differences in cost.

Conclusions

A family-based social work intervention for children and adolescents who have deliberately poisoned themselves is as cost-effective as routine care alone.

Type
Papers
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Declaration of interest

Research supported by the Department of Health, London.

References

Bland, M. (1995) An Introduction to Medical Statistics. Oxford: Oxford University Press.Google Scholar
Drummond, M. F. (1980) Principles of Economic Appraisal in Health Care. Oxford: Oxford University Press.Google Scholar
Goldberg, D. (1978) General Health Questionnaire. Windsor: NFER-Nelson.Google Scholar
Harrington, R., Kerfoot, M., Dyer, E., et al (1998) Randomized trial of a home based family intervention for children who have deliberately poisoned themselves. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 512518.Google Scholar
Hawton, K. (1989) Controlled studies of psychosocial intervention following attempted suicide. In Current Research on Suicide and Parasuicide (eds Platt, S. D. & Kreitman, N.), pp. 180195. Edinburgh: Edinburgh University Press.Google Scholar
Kazdin, A. E., Rodgers, A. & Colbus, D. (1986) The hopelessness scale for children: psychometric characteristics and concurrent validity. Journal of Consulting and Clinical Psychology, 54, 241245.Google Scholar
Kerfoot, M. (1988) Deliberate self-poisoning in childhood and early adolescence. Journal of Child Psychology and Psychiatry, 29, 335343.Google Scholar
Kerfoot, M., Harrington, R. & Dyer, E. (1995) Brief home-based intervention with young suicide attempters and their families. Journal of Adolescence, 18, 557568.Google Scholar
Kerfoot, M., Dyer, E., Harrington, V., et al (1994) Correlates and short-term course of self-poisoning in adolescents. British Journal of Psychiatry, 168, 3842.CrossRefGoogle Scholar
Knapp, M. (1997) Economic evaluations and interventions for children and adolescents with mental health problems. Journal of Child Psychology and Psychiatry, 38, 325.Google Scholar
Kurtz, Z., Thornes, R. & Wolkind, S. (1994) Services for the Mental Health of Children and young People in England: A Review. London: South Thames Regional Health Authority.Google Scholar
Macdonald, G. (1997) Social work: beyond control? In Non-Random Reflections on Health Services Research (eds Maynard, A. & Chalmers, I.), pp. 122146. London: BMJ Publishing.Google Scholar
Miller, I. V., Epstein, N. B., Bishop, D. S., et al (1985) The McMaster Family Assessment Device: reliability and validity. Journal of Marital and Family Therapy, 11, 345356.Google Scholar
Netten, A. & Dennett, J. (1994) Unit Costs of Health and Social Care. University of Kent. Canterbury: Personal Social Services Research Unit.Google Scholar
Parliamentary Select Committee (1997) Number 4: Mental Health Services for Children. London: HMSO.Google Scholar
Puig-Antich, J. & Chambers, W. (1978) The Schedule for Affective Disorders and Schizophrenia for School-Aged Children. New York: New York State Psychiatric Institute.Google Scholar
Reynolds, W. M. (1988) Suicidal Ideation Questionnaire. Professional Manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
Rutter, M. & Quinton, D. (1984) Parental psychiatric disorder: effects on children. Psychological Medicine, 14, 853880.Google Scholar
Sadowski, C. & Kelly, M. L. (1991) Social problem solving in suicidal adolescents. Journal of Consulting and Clinical Psychology, 61, 121127.CrossRefGoogle Scholar
Wood, A. J., Harrington, R. C. & Moore, A. (1996) Controlled trial of a brief cognitive-behavioural intervention in adolescent patients with depressive disorders. Journal of Child Psychology and Psychiatry, 37, 737746.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.