Measurement of Family Costs of Child Mental Illness

描述(由申请人提供)：最近的研究表明，儿童的心理健康问题会给家庭带来巨大的压力和负担，包括感觉到的经济压力。然而，用于衡量儿童心理健康状况的家庭负担的工具并不提供与儿童心理健康问题有关的家庭成本的定量估计。我们将家庭成本定义为1)与儿童精神健康状况有关的商品和服务的货币支出(例如，心理治疗访问的共同支付，家庭的药物支出)，2)家庭成员花费在与儿童精神健康状况相关的活动上的时间(例如，由于儿童精神健康状况而增加的照顾时间，与保险、提供者和学校协调服务的时间)，以及3)与儿童健康状况有关的父母就业的变化(例如，由于与儿童精神健康状况有关的需求而减少或离开有偿工作)。我们只确定了几项英国试点研究，这些研究收集了与生育有心理健康问题的孩子相关的这些类型的家庭成本的综合数据。这些研究为衡量家庭成本的重要问题和方法问题提供了一些指导。然而，到目前为止，美国还没有一项研究收集到与儿童心理健康状况有关的家庭成本的全面数据。造成这一研究差距的一个原因是缺乏专门设计来衡量与儿童心理健康状况有关的家庭成本的综合调查工具。我们建议开发和试行一种工具，以衡量与儿童心理健康问题相关的家庭成本。为简单起见，以下我们将把该工具称为家庭资源和费用调查(FRCS)。我们建议采用定性和定量相结合的方法来开发和测试这一新工具的可行性和可接受性。这项研究还将使我们能够获得设计更大规模研究所需的初步数据，使我们能够估计儿童精神健康疾病给家庭带来的成本，改进干预措施的成本效益分析，并分析影响儿童精神健康疾病的金融政策。

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.