Working Paper: NBER ID: w27890
Authors: Emily Cuddy; Janet Currie
Abstract: Many mental health disorders start in adolescence and appropriate initial treatment may improve trajectories. But what is appropriate treatment? We use a large national database of insurance claims to examine the impact of initial mental health treatment on the outcomes of adolescent children over the next two years, where treatment is either consistent with FDA guidelines, consistent with looser guidelines published by professional societies (“grey-area” prescribing), or inconsistent with any guidelines (“red-flag” prescribing). We find that red-flag prescribing increases self-harm, use of emergency rooms, and health care costs, suggesting that treatment guidelines effectively scale up good treatment in practice.
Keywords: mental health; adolescents; treatment guidelines; FDA; self-harm
JEL Codes: I1; I11
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| red-flag prescribing (L65) | likelihood of self-harm (I12) |
| red-flag prescribing (L65) | emergency room usage (I11) |
| red-flag prescribing (L65) | overall health care costs (I10) |
| FDA-approved prescribing (L65) | initial rates of self-harm (I12) |
| FDA-approved prescribing (L65) | costs over a two-year horizon (J32) |
| grey-area prescribing (I18) | costs (J30) |
| grey-area prescribing (I18) | facility use (R53) |
| grey-area prescribing (I18) | likelihood of self-harm (I12) |