[go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/p/ehl/lserod/56773.html
   My bibliography  Save this paper

Investing in recovery: making the business case for effective interventions for people with schizophrenia and psychosis

Author

Listed:
  • Knapp, Martin
  • Andrew, Alison
  • McDaid, David
  • Iemmi, Valentina
  • McCrone, Paul
  • Park, A-La
  • Parsonage, Michael
  • Boardman, Jed
  • Shepherd, Geoff
Abstract
The health service spent £2.0 billion on services for people with psychosis in 2012/13. Over half (54%) of this total was devoted to inpatient care. This means that spending is currently skewed towards the more expensive parts of the system, at £350 average cost per day for inpatient care compared with £13 average cost per day in community settings. There is a strong business case for investing in the early intervention and community-based interventions proven to generate savings or value-for-money gains through reduced inpatient admission, or through other routes. This report provides the most up-to-date economic evidence to support the business case for investment in effective, recovery-focused services. Drawing on a wide range of data, evidence for the cost-effectiveness of recovery-focused interventions is set out: • Early Detection (ED) services • Early Intervention (EI) teams • Individual Placement and Support (IPS) • Family therapy • Criminal justice liaison and diversion • Physical health promotion, including health behaviours • Supported housing • Crisis Resolution and Home Treatment (CRHT) teams • Crisis houses • Peer support • Self-management • Cognitive Behavioural Therapy (CBT) • Anti-stigma and discrimination campaigns • Personal Budgets (PBs) • Welfare advice Many of these interventions are shown to be cost-effective, in some cases due to the role they play inpreventing or delaying relapse, or reducing the need for the most expensive care. Some have much wider benefits related to wider recovery outcomes, such as employment, settled housing and better physical health. There is particularly clear evidence for interventions such as EI teams, IPS for employment, CBT and CRHT teams. However, there is evidence to suggest that all of the above interventions contribute to recovery outcomes, reduced costs and/or better value for money. Illustrative examples of the savings incurred through particular interventions include: • Early Intervention: net savings of £7,972 per person after four years. Over a ten-year period, £15 in costs can be avoided for every £1 invested. • Smoking cessation: £1,255 to gain an extra Quality-Adjusted Life Year (QALY), which lies well below the upper threshold of £30,000 recommended by National Institute for Health and Care Excellence (NICE). • Peer support: £4.76 can be gained for every £1 invested. • CBT: Cost per QALY gained of £27,373 for CBT compared to usual care, which is below the upper threshold used by NICE. Local and regional commissioning and pathway development should draw on this evidence, since these interventions are both clinically effective and many will contribute to savings to be reinvested in care. While the scope of this report is primarily at intervention level, the intention is to inform local implementation.

Suggested Citation

  • Knapp, Martin & Andrew, Alison & McDaid, David & Iemmi, Valentina & McCrone, Paul & Park, A-La & Parsonage, Michael & Boardman, Jed & Shepherd, Geoff, 2014. "Investing in recovery: making the business case for effective interventions for people with schizophrenia and psychosis," LSE Research Online Documents on Economics 56773, London School of Economics and Political Science, LSE Library.
    • Handle: RePEc:ehl:lserod:56773
    as

    Download full text from publisher

    File URL: http://eprints.lse.ac.uk/56773/
    File Function: Open access version.
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Knapp, Martin & McDaid, David & Parsonage, Michael, 2011. "Mental health promotion and mental illness prevention: the economic case," LSE Research Online Documents on Economics 32311, London School of Economics and Political Science, LSE Library.
    2. Karen Jones & Ann Netten & José-Luis Fernández & Martin Knapp & David Challis & Caroline Glendinning & Sally Jacobs & Jill Manthorpe & Nicola Moran & Martin Stevens & Mark Wilberforce, 2012. "The impact of individual budgets on the targeting of support: findings from a national evaluation of pilot projects in England," Public Money & Management, Taylor & Francis Journals, vol. 32(6), pages 417-424, November.
    3. A. Russolillo & M. Patterson & L. McCandless & A. Moniruzzaman & J. Somers, 2014. "Emergency department utilisation among formerly homeless adults with mental disorders after one year of Housing First interventions: a randomised controlled trial," International Journal of Housing Policy, Taylor & Francis Journals, vol. 14(1), pages 79-97, January.
    4. Trachtenberg, Marija & Parsonage, Michael & Shepherd, Geoff & Boardman, Jed, 2013. "Peer support in mental health care: is it good value for money?," LSE Research Online Documents on Economics 60793, London School of Economics and Political Science, LSE Library.
    5. Greve, Jane & Nielsen, Louise Herrup, 2013. "Useful beautiful minds—An analysis of the relationship between schizophrenia and employment," Journal of Health Economics, Elsevier, vol. 32(6), pages 1066-1076.
    6. Pascoe Pleasence & Nigel J. Balmer, 2007. "Changing Fortunes: Results from a Randomized Trial of the Offer of Debt Advice in England and Wales," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 4(3), pages 651-673, November.
    7. A. Russolillo & M. Patterson & L. McCandless & A. Moniruzzaman & J. Somers, 2014. "Emergency department utilisation among formerly homeless adults with mental disorders after one year of Housing First interventions: a randomised controlled trial," European Journal of Housing Policy, Taylor and Francis Journals, vol. 14(1), pages 79-97, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Tighe Margaret & Murphy Caroline, 2020. "Facilitating the employment of people with mental health difficulties in Ireland," The Irish Journal of Management, Sciendo, vol. 40(1), pages 13-26, July.
    2. Rubina Jhadray & Gráinne Fadden & Martin Atchison & Paula Conneely & Julia Danks & Alison Lee & Chris Mansell, 2015. "Applying the Behavioural Family Therapy Model in Complex Family Situations," Social Sciences, MDPI, vol. 4(2), pages 1-10, June.
    3. Eilish M Burke & Melissa Pyle & Karen Machin & Anthony P Morrison, 2018. "Providing mental health peer support 1: A Delphi study to develop consensus on the essential components, costs, benefits, barriers and facilitators," International Journal of Social Psychiatry, , vol. 64(8), pages 799-812, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kristy Buccieri, 2016. "Integrated Social Housing and Health Care for Homeless and Marginally-Housed Individuals: A Study of the Housing and Homelessness Steering Committee in Ontario, Canada," Social Sciences, MDPI, vol. 5(2), pages 1-17, March.
    2. Ciara Keenan & Sarah Miller & Jennifer Hanratty & Terri Pigott & Jayne Hamilton & Christopher Coughlan & Peter Mackie & Suzanne Fitzpatrick & John Cowman, 2021. "Accommodation‐based interventions for individuals experiencing, or at risk of experiencing, homelessness," Campbell Systematic Reviews, John Wiley & Sons, vol. 17(2), June.
    3. Thomas Barnay & Éric Defebvre, 2019. "Gender Differences in the Influence of Mental Health on Job Retention," LABOUR, CEIS, vol. 33(4), pages 507-532, December.
    4. Christoph Kronenberg, 2021. "New(spaper) evidence of a reduction in suicide mentions during the 19th century US gold rush," Health Economics, John Wiley & Sons, Ltd., vol. 30(10), pages 2582-2594, September.
    5. Lynn, Peter & Fumagalli, Laura & Muñoz-Bugarin, Jair, 2021. "The effect of formal debt advice on financial management and knowledge: insights from a new longitudinal study in Britain," ISER Working Paper Series 2021-09, Institute for Social and Economic Research.
    6. Richard Layard & Andrew E. Clark & Francesca Cornaglia & Nattavudh Powdthavee & James Vernoit, 2014. "What Predicts a Successful Life? A Life‐course Model of Well‐being," Economic Journal, Royal Economic Society, vol. 124(580), pages 720-738, November.
    7. Belloni, Michele & Carrino, Ludovico & Meschi, Elena, 2022. "The impact of working conditions on mental health: Novel evidence from the UK," Labour Economics, Elsevier, vol. 76(C).
    8. Henri Salokangas, 2021. "Exploring the labor market consequences of psychiatric disorders: An event study approach," Discussion Papers 148, Aboa Centre for Economics.
    9. Hazo, Jean-Baptiste & Gandré, Coralie & Leboyer, Marion & Obradors-Tarragó, Carla & Belli, Stefano & McDaid, David & Park, A-La & Maliandi, Maria Victoria & Wahlbeck, Kristian & Wykes, Til & van Os, J, 2017. "National funding for mental health research in Finland, France, Spain and the United Kingdom," LSE Research Online Documents on Economics 82339, London School of Economics and Political Science, LSE Library.
    10. Knapp, Martin & Wong, Gloria, 2020. "Economics and mental health: the current scenario," LSE Research Online Documents on Economics 102717, London School of Economics and Political Science, LSE Library.
    11. Karim Naderi Mahdei & Mehrdad Pouya & Fatemeh Taheri & Hossein Azadi & Steven Van Passel, 2015. "Sustainability Indicators of Iran’s Developmental Plans: Application of the Sustainability Compass Theory," Sustainability, MDPI, vol. 7(11), pages 1-14, November.
    12. Wolf, Tobias, 2020. "Welfare while working: How does the life satisfaction approach help to explain job search behavior?," Discussion Papers 2020/14, Free University Berlin, School of Business & Economics.
    13. Gregory S. Anderson & Rosemary Ricciardelli & Linna Tam-Seto & Sulaimon Giwa & R. Nicholas Carleton, 2022. "Self-Reported Coping Strategies for Managing Work-Related Stress among Public Safety Personnel," IJERPH, MDPI, vol. 19(4), pages 1-14, February.
    14. McDaid, David & Park, A-La & Wahlbeck, Kristian, 2019. "The economic case for the prevention of mental illness," LSE Research Online Documents on Economics 100054, London School of Economics and Political Science, LSE Library.
    15. Layard, Richard & Chisholm, Dan & Patel, Vikram & Saxena, Shekhar, 2013. "Mental Illness and Unhappiness," IZA Discussion Papers 7620, Institute of Labor Economics (IZA).
    16. Ziggi Ivan Santini & Hannah Becher & Maja Bæksgaard Jørgensen & Michael Davidsen & Line Nielsen & Carsten Hinrichsen & Katrine Rich Madsen & Charlotte Meilstrup & Ai Koyanagi & Sarah Stewart-Brown & D, 2021. "Economics of mental well-being: a prospective study estimating associated health care costs and sickness benefit transfers in Denmark," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(7), pages 1053-1065, September.
    17. Rasmus Landersø & Peter Fallesen, 2021. "Psychiatric hospital admission and later crime, mental health, and labor market outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 30(1), pages 165-179, January.
    18. Diby, Akissi S. & Lengagne, Pascale & Regaert, Camille, 2021. "Employment Vulnerability of People With Severe Mental Illness," Health Policy, Elsevier, vol. 125(2), pages 269-275.
    19. Evans-Lacko, Sara & Knapp, Martin & McCrone, Paul & Thornicroft, Graham & Mojtabai, Ramin, 2013. "The mental health consequences of the recession: economic hardship and employment of people with mental health problems in 27 European countries," LSE Research Online Documents on Economics 51632, London School of Economics and Political Science, LSE Library.
    20. Eilish M Burke & Melissa Pyle & Karen Machin & Anthony P Morrison, 2018. "Providing mental health peer support 1: A Delphi study to develop consensus on the essential components, costs, benefits, barriers and facilitators," International Journal of Social Psychiatry, , vol. 64(8), pages 799-812, December.

    More about this item

    JEL classification:

    • E6 - Macroeconomics and Monetary Economics - - Macroeconomic Policy, Macroeconomic Aspects of Public Finance, and General Outlook

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ehl:lserod:56773. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: LSERO Manager (email available below). General contact details of provider: https://edirc.repec.org/data/lsepsuk.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.