The role of youth mental health services in the treatment of young people with serious mental illness: two-year outcomes and economic implications

Aim: To evaluate the outcomes and economic case for a UK innovative youth-specific mental health service for 16 to 25 year olds.

Methods: A pre-, during- and post-treatment comparative design for twenty young people at high risk of developing psychosis who received two years’ treatment with the service, using outcomes that concurred with the service aims: changes in mental health, employment rates and service use.

Results: 45% of those at risk and with symptoms of serious mental illness commencing treatment were not receiving mental health services at baseline.. Compared to service use prior to treatment at the youth-specific service, hospital admissions, A&E and criminal justice system use appear to decrease over the two years of treatment and the year after treatment, with potential cost differences of £473,000. Mental health improved or stayed the same, compared to baseline. Employment rates improved, although the sample size for this is very small. Potential cost differences associated with service users moving into employment over the two years are £148,000. The estimated cost over two years of providing the youth-specific mental health service to these young people was £106,000.

Conclusions: Given the extensive long-term negative consequences and high costs of untreated mental illness in the 16 to 25 age group and the documented problems young people have in receiving appropriate services, this youth-specific, age-appropriate service model appears to be successful, with improved outcomes and cost differences in the short-term, and with encouraging implications for the longer term.