Cost effective early intervention of child mental health disorders

California

CDC data indicate that 11% of children are diagnosed with Attention Deficit Hyperactivity Disorder, and other disruptive behavior disorders.  Currently, treatment of ADHD is the second highest cost for all of child health care, with annual costs of over $20.6 billion in 2013.  The first line treatment recommended for children over 6 years are stimulant medicines and for children 5 and under, behavioral parent training.   The etiology of ADHD is not entirely clear. As with all other behavior disorders, it is a function of modifiable factors and the symptoms of hyperactivity and impulsivity emerge in the second year of life but therapeutic intervention between two and five years is rarely offered.   Diagnosis of ADHD is frequently confused with other disorders and the medication treatments of ADHD are not appropriate for many children.  There exist well-researched, low cost interventions that can prevent and treat childhood behavior problems.  Recently a number of these approaches have been successfully delivered within primary care settings with good results.  The impact of these treatment programs less costly and superior to medication treatment.  Redesign of pediatric services to include early screening of behavior and implementation of evidence based, effective psychological interventions can result in better outcome, and lower costs for child health care.  A current Collaborative on Healthy Parenting at the National Academy of Medicine has defined appropriate effective interventions for primary care and endorsed funding those through the current health care system.   A summary of the Healthy Parenting collaborative will be provided.

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