Andrew T. Healey

Economic impact of childhood psychiatric disorder on public sector services in Britain: estimates from national survey data

BACKGROUND Approximately one in ten children aged 5-15 in Britain has a conduct, hyperactivity or emotional disorder. METHODS The British Child and Adolescent Mental Health Surveys (BCAMHS) identified children aged 5-15 with a psychiatric disorder, and their use of health, education and social care services. Service costs were estimated for each child and weighted to estimate the overall economic impact at national level. RESULTS Additional health, social care and education costs associated with child psychiatric disorders totalled £1.47bn in 2008. The lions share of the costs falls to frontline education and special education services. CONCLUSIONS There are huge costs to the public sector associated with child psychiatric disorder, particularly the education system. There is a pressing need to explore ways to reduce these costs while improving health and well-being.

Adult labour market implications of antisocial behaviour in childhood and adolescence: findings from a UK longitudinal study

While antisocial behaviour in younger age groups is largely viewed as a public externality issue, there are also reasons for expecting less favourable life-course outcomes for those individuals who follow antisocial developmental pathways. Data from a UK longitudinal study of delinquent development in a cohort of working class boys are used to model the adult labour market implications of different antisocial developmental pathways to age 32. A series of probit estimations suggests that children identified as troublesome by peers and teachers at an early age, and who subsequently engaged in delinquent behaviour throughout their adolescence, had a significantly higher probability of experiencing long periods of time out of the workforce prior to age 32 and lengthy periods of unemployment and/or low paid work at both age 18 and at age 32. A Heckman selectivity model estimated on weekly earnings at age 32 does not provide evidence that antisocial development in children and adolescents is associated with a lower wage. However, the findings from a two-part model suggest that antisocial boys will have significantly lower levels of expected earnings from employment at 32 years––an effect that is almost entirely the result of lower rates of workforce participation. While a full causal, structural model of labour outcomes is not developed, there is tentative evidence that relatively poor employment outcomes for antisocial boys are mediated through poor educational attainment at secondary school and higher rates of criminal conviction in early adulthood.