Jill Furzer: Diagnostic errors in child mental health: Assessing treatment selection and its long-term consequences
4 décembre 2020
Heure: 10h30 - 11h45
Conférencière : Jill Furzer (Toronto)
Invitée par : Maripier Isabelle
The subjective nature of mental health diagnoses may cause missed diagnoses in some children and over-treatment in others, with differences by gender, race and socioeconomic status. To test for this, I estimate mental health risk in childhood using nationally representative health data. I calculate over-diagnosis by estimating risk-specific jumps in diagnosis by a child's school starting age. I find diagnosed young-for-grade children have a lower risk of mental illness, while many high-risk kids remain undiagnosed. Underdiagnosis appears to be driven by internalized mental health symptoms and pro-social behaviours leading to symptom masking, which is especially common in females. I investigate the impact of over- and under-treatment on longer-run outcomes—including educational attainment and the likelihood of social assistance receipt—using linked tax records. My results suggest that adverse treatment effects on education, social assistance receipt and income are concentrated in low-risk, over-treated individuals. However, mental health treatments improve these outcomes for high-risk children and accrue sizable improvements in the form of reduced rates of workplace injuries and suicide ideation. As missed or delayed diagnoses represent a larger misallocation of scarce support resources, these results suggest that targeted screening before age 11 would reduce inequities in diagnosing mental illness and downstream socioeconomic inequalities.