The Dynamics of Child and Adolescent Mental Health Care

We estimate the persistence of secondary psychiatric care for a population of Dutch children and adolescents between 2000 and 2012. We develop a theoretical model to estimate the true state-dependence of child and adolescent mental health care using administrative data from the Psychiatric Case Registry Northern Netherlands (PCR-NN). We obtained consistent estimates for the true state-dependence by using difference General Method of Moments (GMM). All estimation results for the true state-dependence show a positive coefficient smaller than unity, which indicates that the process is stable. An exogenous increase of 10 care moments in the present year is associated with approximately a total of 11 additional care moments in the future. The role of spurious state-dependence is likely small. Estimates are robust to numerous sensitivity analyses.