Defining and Predicting High Cost Utilization in Children’s Outpatient Mental Health Services

  • Kelsey S. DicksonEmail author
  • Nicole A. Stadnick
  • Teresa Lind
  • Emily V. Trask
Original Paper


Little is known about high-cost service users in the context of youth outpatient mental health, despite the fact that they account for a large proportion of overall mental healthcare expenditures. A nuanced understanding of these users is critical to develop and implement tailored services, as well as to inform relevant policies. This study aims to characterize high-cost service users by examining demographic factors, diagnoses, and service type use. Administrative service use data were extracted from a large County Department of Behavioral Health Services database. Latent profile analyses suggest a four-profile solution primarily distinguished by youth age and diagnostic complexity. Study findings have implications for defining high-cost service users and key targets for efforts aiming to improve outcomes for these youth.


Public mental health services Youth High-cost users Pattern-oriented approach 



This study was supported by funding from the San Diego County Behavioural Health Services, Health and Human Services Agency as well as NIMH Grant K23 MH115100 and NIMH Grant K23 MH110602.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest

Ethical Approval

Ethics approval for this study was obtained from the UC San Diego Human Research Protection Program (HRPP). These data were collected as part of evaluation activities and analyses were conducted using an anonymized dataset.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Kelsey S. Dickson
    • 1
    • 2
    Email author
  • Nicole A. Stadnick
    • 2
    • 3
  • Teresa Lind
    • 2
    • 3
  • Emily V. Trask
    • 2
    • 3
  1. 1.Department of Child and Family DevelopmentSan Diego State UniversitySan DiegoUSA
  2. 2.Child and Adolescent Services Research CenterSan DiegoUSA
  3. 3.Department of PsychiatryUniversity of California, San DiegoLa JollaUSA

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