Service- and practitioner-level variation in non-consensual dropout from child mental health services

Julian Edbrooke-Childs (Lead / Corresponding author), Jan R. Boehnke, Victoria Zamperoni, Ana Calderon, Andy Whale

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    4 Citations (Scopus)
    63 Downloads (Pure)

    Abstract

    Non-attendance of mental health service appointments is an international problem. In the UK, for example, the estimated cost of non-attendance in child mental health services is over £45 million (US dollar 60.94 million) per annum. The objective of this study was to examine whether there were service- and practitioner-level variation in non-consensual dropout in child mental health services. This was an analysis of routinely collected data. Service-level variation (as services covered different geographic areas) and practitioner-level variation were examined in N = 3622 children (mean age 12.70 years; SD 3.62, 57% female, 50% white or white British) seen by 896 practitioners across 39 services. Overall, 35% of the variation in non-consensual dropout was explained at the service level and 15% at the practitioner level. Children were almost four times more likely to drop out depending on which service they attended (median odds ratio = 3.92) and were two-and-a-half times more likely to drop out depending on which practitioner they saw (median odds ratio = 2.53). These levels of variation were not explained by levels of deprivation in areas covered by services or by children’s demographic and case characteristics. The findings of the present research may suggest that, beyond service-level variation, there is also practitioner-level variation in non-consensual dropout in child mental health services.
    Original languageEnglish
    Pages (from-to)929-934
    Number of pages6
    JournalEuropean Child & Adolescent Psychiatry
    Volume29
    Issue number7
    Early online date21 Sep 2019
    DOIs
    Publication statusPublished - 1 Jul 2020

    Keywords

    • Adolescent mental health
    • risk adjustment
    • service-level variation
    • nonconsensual dropout
    • Risk adjustment
    • Non-consensual dropout
    • Service-level variation

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