Treatment costs for youths receiving multisystemic therapy or hospitalization after a psychiatric crisis

Psychiatr Serv. 2004 May;55(5):548-54. doi: 10.1176/


Objective: The authors conducted a cost analysis for multisystemic therapy, an evidence-based treatment that is used as an intensive community-based alternative to the hospitalization of youths presenting with psychiatric emergencies.

Methods: Data from a randomized clinical trial that compared multisystemic therapy with usual inpatient services followed by community aftercare were used to compare Medicaid costs and clinical outcomes during a four-month period postreferral and a 12-month follow-up period. Data were from 115 families receiving Medicaid (out of 156 families in the clinical trial).

Results: During the four months postreferral, multisystemic therapy was associated with an average net savings per youth treated of $1,617 compared with usual services. Costs during the 12-month follow-up period were similar between treatments. Multisystemic therapy demonstrated better short-term cost-effectiveness for each of the clinical outcomes (externalizing behavior, internalizing behavior, and global severity of symptoms) than did usual inpatient care and community aftercare. The two treatments demonstrated equivalent long-term cost-effectiveness.

Conclusions: Among youths presenting with psychiatric emergencies, multisystemic therapy was associated with better outcomes at a lower cost during the initial postreferral period and with equivalent costs and outcomes during the 12-month follow-up period.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Child
  • Cost-Benefit Analysis
  • Female
  • Follow-Up Studies
  • Health Care Costs
  • Hospitalization / economics*
  • Humans
  • Male
  • Medicaid / economics
  • Mental Disorders / economics*
  • Mental Disorders / rehabilitation
  • Mental Disorders / therapy*
  • Mental Health Services / economics*
  • Mental Health Services / organization & administration*
  • United States