Mental health service utilization in autism spectrum disorders

• We assess mental health service use by comorbidity, modality and provider among children, adolescents, and adults.
• Family therapy had the shortest treatment length and lowest cost.
• Mixed therapy is much longer and costlier than either family or individual therapy, and also has lower rates of dropout and return to care.
• Children have higher outpatient mental health dropout than any other age group and across all modes of therapy.

PurposeThe purpose of this study is to examine patterns in autism spectrum disorder (ASD) outpatient mental health services including cost and length of services, return to care rates, and dropout by the presence of commonly co-morbid mental health conditions, modality and provider type.MethodologyThis study is a longitudinal, retrospective study using administrative data from Cigna, a leading health care insurance provider in the U.S. Participants (n = 1614, ages 1–61) included individuals diagnosed with an ASD from 2001 to 2006, who had claims for outpatient mental health services.ResultsAcross all age groups, the cost and length variables were lowest for family therapy, followed by individual therapy. Mixed therapy (combination of family and individual therapy) was significantly longer and more costly. Rates of dropout and return to care were lowest for mixed therapy. Dropout was significantly higher for children than for adults or adolescents. Among provider types, social workers had the lowest cost among adolescents and the highest return to care rates among adults and counselors had the longest service length and the lowest dropout rates among children.