New Perspectives on the Economics of Mental Health
Paper Session
Saturday, Jan. 6, 2024 8:00 AM - 10:00 AM (CST)
- Chair: Janet Currie, Princeton University
SPILLOVERS AND TRAINING EFFECTS ON MENTAL HEALTH PRESCRIBING FOR CHILDREN
Abstract
A large literature suggests that similar patients are often treated quite differently across geographic areas. This literature usually focuses on treatment of the elderly, and on area-level explanators external to individual physicians. We provide evidence of important variations in physician practice style in a new context – the prescribing of psychiatric medications to children.This setting is of interest because as many as 20% of children will be affected by mental illness at some point in time. Guidelines for first time treatment of children with mental health issues are relatively clear, so we can examine “red-flag” prescribing. A third feature of this setting is that children may be treated either by psychiatrists (highly trained) or by general practitioners (who have less training in child psychiatry).
We find that individual physician fixed effects are important, but that there is also cohort-level evolution in practice style over time. Physicians trained in similarly ranked schools at the same time evolve similarly across the country. Spillovers are important, but they are more important for general practitioners than for psychiatrists, suggesting that specific training can mitigate the spread of harmful practices. These results suggest that identifying influential doctors within networks could be a way to improve medical practice.
Early Home Visiting Delivery Model and Maternal and Child Mental Health at Primary School Age
Abstract
Home visiting programs aimed at improving parenting skills and the home environment in early childhood have become increasingly popular worldwide. While many of these programs have been evaluated, there is little evidence on several features apparently critical to their success, such as the qualifications of home visitors, and the continuity of their relationship with the client. In this paper we exploit a unique, unexplored feature of the randomized evaluation of the German home visiting program Pro Kind to shed some light on this question. Depending on the geographical location (site) in Germany, the intervention was delivered according to one of two models. In the first model, families were visited by the same home visitor, a midwife, throughout the whole intervention period (from pregnancy to the child’s second birthday). In the second model, a midwife conducted the home visits only from pregnancy to six months of age; she was then replaced by a social worker who conducted the home visits up to the child’s second birthday. We study the 5-year impacts of the different Pro Kind delivery models on maternal and child mental health, objectively measured using fully standardized diagnostic interviews.Discussant(s)
Prashant Bharadwaj
,
University of California-San Diego
David Chan
,
Stanford University
Janet Currie
,
Princeton University
JEL Classifications
- I1 - Health