TY - JOUR
T1 - The healthcare resource impact of maternal mental illness on children and adolescents: UK retrospective cohort study, has been published in The British Journal of Psychiatry
AU - Hope, Holly
AU - Abel, Kathryn
AU - Osam, Nejla Cemre Su
AU - Pierce, Matthias
AU - Ashcroft, Darren
AU - Munford, Luke
AU - Kontopantelis, Evan
AU - Hughes, Sian
N1 - Funding Information:
This project has received funding from the European Research Council under the European Union's Horizon 2020 research and innovation programme (grant agreement GA682741), and the National Institute for Health Research (reference 111905). The funders had no role in the design, analysis or reporting of the study.
Publisher Copyright:
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.
PY - 2021/5/21
Y1 - 2021/5/21
N2 - BACKGROUND: The general health of children of parents with mental illness is overlooked.AIMS: To quantify the difference in healthcare use of children exposed and unexposed to maternal mental illness (MMI).METHOD: This was a retrospective cohort study of children aged 0-17 years, from 1 April 2007 to 31 July 2017, using a primary care register (Clinical Practice Research Datalink) linked to Hospital Episodes Statistics. MMI included non-affective/affective psychosis and mood, anxiety, addiction, eating and personality disorders. Healthcare use included prescriptions, primary care and secondary care contacts; inflation adjusted costs were applied. The rate and cost was calculated and compared for children exposed and unexposed to MMI using negative binomial regression models. The total annual cost to NHS England of children with MMI was estimated.RESULTS: The study included 489 255 children: 238 106 (48.7%) girls, 112 741 children (23.0%) exposed to MMI. Compared to unexposed children, exposed children had a higher rate of healthcare use (rate ratio 1.27, 95% CI 1.26-1.28), averaging 2.21 extra contacts per exposed child per year (95% CI 2.14-2.29). Increased healthcare use among exposed children occurred in inpatients (rate ratio 1.37, 95% CI 1.32-1.42), emergency care visits (rate ratio 1.34, 95% CI 1.33-1.36), outpatients (rate ratio 1.30, 95% CI 1.28-1.32), prescriptions (rate ratio 1.28, 95% CI 1.26-1.30) and primary care consultations (rate ratio 1.24, 95% CI 1.23-1.25). This costs NHS England an additional £656 million (95% CI £619-£692 million), annually.CONCLUSIONS: Children of mentally ill mothers are a health vulnerable group for whom targeted intervention may create benefit for individuals, families, as well as limited NHS resources.
AB - BACKGROUND: The general health of children of parents with mental illness is overlooked.AIMS: To quantify the difference in healthcare use of children exposed and unexposed to maternal mental illness (MMI).METHOD: This was a retrospective cohort study of children aged 0-17 years, from 1 April 2007 to 31 July 2017, using a primary care register (Clinical Practice Research Datalink) linked to Hospital Episodes Statistics. MMI included non-affective/affective psychosis and mood, anxiety, addiction, eating and personality disorders. Healthcare use included prescriptions, primary care and secondary care contacts; inflation adjusted costs were applied. The rate and cost was calculated and compared for children exposed and unexposed to MMI using negative binomial regression models. The total annual cost to NHS England of children with MMI was estimated.RESULTS: The study included 489 255 children: 238 106 (48.7%) girls, 112 741 children (23.0%) exposed to MMI. Compared to unexposed children, exposed children had a higher rate of healthcare use (rate ratio 1.27, 95% CI 1.26-1.28), averaging 2.21 extra contacts per exposed child per year (95% CI 2.14-2.29). Increased healthcare use among exposed children occurred in inpatients (rate ratio 1.37, 95% CI 1.32-1.42), emergency care visits (rate ratio 1.34, 95% CI 1.33-1.36), outpatients (rate ratio 1.30, 95% CI 1.28-1.32), prescriptions (rate ratio 1.28, 95% CI 1.26-1.30) and primary care consultations (rate ratio 1.24, 95% CI 1.23-1.25). This costs NHS England an additional £656 million (95% CI £619-£692 million), annually.CONCLUSIONS: Children of mentally ill mothers are a health vulnerable group for whom targeted intervention may create benefit for individuals, families, as well as limited NHS resources.
KW - Adolescent
KW - Anxiety Disorders
KW - Child
KW - Delivery of Health Care
KW - England/epidemiology
KW - Female
KW - Humans
KW - Mental Disorders/epidemiology
KW - Retrospective Studies
U2 - 10.1192/bjp.2021.65
DO - 10.1192/bjp.2021.65
M3 - Article
C2 - 35048862
SN - 0007-1250
VL - 219
SP - 515
EP - 522
JO - The British Journal of Psychiatry.
JF - The British Journal of Psychiatry.
IS - 3
ER -