Early intervention for first-episode psychosis: broadening the scope of economic estimates

October 13, 2014

by A-La Park, Paul McCrone and Martin Knapp

In April the BBC reported that mental health trust budgets for 2013-14 fell by 2.3% since 2011-12. Under current budget constraints, it has become increasingly important to demonstrate good value for money when allocating scarce resources. In a recent study funded by the Department of Health we found that investing in early-intervention services for young people experiencing early psychosis can be financially advantageous in both the medium- and long-term.

Our findings

Our recent article in Early Intervention in Psychiatry explored potential cost-savings that could be achieved through earlier intervention for people who have experienced first-episode psychosis. We found that early intervention as a multidisciplinary team approach targeting young people aged 18-35 can generate £2,087 of savings per person over a three-year period through improved participation in educational activities and a better contribution to the labour market.

Yearly savings of £957 per service user can be achieved over four years by averting suicide events. Over ten years, the costs per year were £80 lower for people who received early intervention relative to standard care. These show that investing in early intervention programmes can be beneficial to the National Health Service as well as other public sectors such as education, employment and criminal justice system.

Developing the evidence base

The first early-intervention programme in the UK started in Birmingham in the 1990’s. Since then, there has been increasing support from national policymakers, and a series of economic evaluations in England have reported positive outcomes.

Publication of our paper was timely following media attention covering a report by Rethink Mental Illness and PSSRU on the economic case for schizophrenia and psychosis interventions launched at April’s inaugural National Psychosis Summit in London. Our study highlights the potential benefit of early intervention for sectors other than health.

While the economic evidence base for early intervention for those having first-episode psychosis is growing worldwide, there is a great need for inter-sectoral collaboration to realise the full monetary benefits of early intervention. More economic studies will help to inform decision-making processes and support the efforts of commissioners, funders and policy-makers to make the economic case for evidence-based practice and policy at the local and national level.

Full paper

Park A, McCrone P, Knapp M (2014) Early intervention for first-episode psychosis: broadening the scope of economic estimates, Early Intervention in Psychiatry, Published online on 17 April 2014 [Epub ahead of print].

The study was funded by the UK Department of Health. The views expressed are those of the authors and not necessarily those of the Department of Health.

For further information, please contact A-La Park (a.park@lse.ac.uk).

About the authors

A-La Park is a Research officer at PSSRU. Her main work interests are in the economics of mental health and well-being promotion across the life-course, as well as on the prevention of accidental and intentional injuries. She focuses in particular on systematic reviewing and economic modelling.

Paul McCrone is Professor of Health Economics and Director of Centre for the Economics of Mental and Physical Health at Institute of Psychiatry. His main work interests are in child and adult mental health.

Martin Knapp is Professor of Social Policy and Director of PSSRU. His main work interests are in social care, child and adult mental health, dementia and autism. He is also Director of the NIHR School for Social Care Research.

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