Measurement of Family Costs of Child Mental Illness

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DESCRIPTION (provided by applicant): Recent studies document that children's mental health problems cause substantial stress and burden to families including perceived economic strain. However, instruments used to measure the family burden of child mental health conditions do not provide quantitative estimates of the family costs associated with child mental health problems. We define family costs as 1) monetary expenditures for goods and services related to child mental health conditions (e.g., co-payments for psychotherapy visits, expenditures by families for medications), 2) time family members spend on activities related to child mental health conditions (e.g., added time spent caregiving due to child mental health conditions, time coordinating services with insurance, providers, and schools), and 3) changes in parent employment related to child conditions (e.g., reducing or leaving paid employment due to demands related to child mental health conditions). We have identified only a few British pilot studies that have collected comprehensive data on these types of family costs associated with having a child with mental health conditions. These studies provide some guidance about important questions to ask and methodological issues in measuring family costs. However, to date, no study in the United States has collected comprehensive data on family costs related to child mental health conditions. One reason for this gap in research is lack of comprehensive survey instruments specifically designed to measure family costs related to child mental health conditions. We propose to develop and pilot test an instrument to measure the family costs associated with child mental health problems. For simplicity we will refer to the instrument as the Family Resource and Cost Survey (FRCS) hereafter. We propose to combine qualitative and quantitative methods to develop and test the feasibility and acceptability of this new instrument. This study will also allow us to obtain preliminary data needed to design a larger-scale study that will enable us to estimate the costs to families of child mental health conditions, improve cost-effectiveness analyses of interventions, and analyze financial policies affecting children with mental health conditions.