Applying economic models to estimate local economic benefits of improved coverage of early intervention for psychosis

Early Interv Psychiatry. 2019 Dec;13(6):1424-1430. doi: 10.1111/eip.12787. Epub 2019 Feb 10.

Abstract

Aim: Early Intervention Psychosis Services (EIPS) for people experiencing First Episode Psychosis (FEP) offer important clinical and non-clinical benefits over standard care. Similarly, intervention for Clinical High Risk for Psychosis state (CHR-P) can prevent psychosis, ameliorate symptoms and have non-clinical benefits. This study aimed to estimate associated local economic benefits of FEP and CHR-P services compared with standard care.

Methods: Across four south London boroughs, proportion of annual number of new cases of FEP and CHR-P seen by early intervention services was estimated. Economic modelling conducted for England's mental health strategy was applied to estimate local economic impacts of current and improved service provision.

Results: Across four London boroughs during 2011/2012, proportion of 15-34 year olds with FEP seen by EIPS was 100.2% assuming 80/100 000 annual incidence whereas proportion with CHR-P seen by CHR-P services was 4.1% assuming 200/100 000 annual incidence. Application of economic modelling suggests that provision of EIPS to reach all new FEP cases each year would free up resources of £13.1m over 10 years including £2.0m to National Health Service (NHS) after the first year. Scaling up to reach all new CHR-P cases each year would free up resources of £19.7m over 10 years with an estimated 10-year cost of implementation gap for each 1 year cohort of £18.9m. An earlier related briefing resulted in increased funding for EIPS and new CHR-P services despite overall cuts to mental health services.

Conclusions: Estimation of local economic impacts of FEP and CHR-P services was associated with improved investment in such services.

Keywords: clinical high-risk for psychosis; early intervention; economic impact; first episode psychosis; prevention; psychosis; risk; schizophrenia.

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Cost Savings / statistics & numerical data*
  • Early Medical Intervention / economics*
  • Female
  • Humans
  • London
  • Male
  • Mental Health Services / economics*
  • Models, Economic*
  • Psychotic Disorders / economics*
  • Psychotic Disorders / psychology
  • Psychotic Disorders / therapy*
  • State Medicine
  • Young Adult