Is early intervention in psychosis cost-effective over the long term?

Mihalopoulos, Cathrine, Harris, Meredith, Henry, Lisa, Harrigan, Susy and McGorry, Patrick 2009, Is early intervention in psychosis cost-effective over the long term?, Schizophrenia bulletin, vol. 35, no. 5, pp. 908-918, doi: 10.1093/schbul/sbp054.

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Title Is early intervention in psychosis cost-effective over the long term?
Author(s) Mihalopoulos, CathrineORCID iD for Mihalopoulos, Cathrine
Harris, Meredith
Henry, Lisa
Harrigan, Susy
McGorry, Patrick
Journal name Schizophrenia bulletin
Volume number 35
Issue number 5
Start page 908
End page 918
Total pages 11
Publisher Oxford University Press
Place of publication Oxford, England
Publication date 2009
ISSN 0586-7614
Keyword(s) economic evaluation
psychotic disorders
mental health care
Summary Objective: This study assesses the long-term cost-effectiveness of a comprehensive model of mental health care for first-episode psychosis. The study is an extension of a previous economic evaluation of the Early Psychosis Prevention and Intervention Centre (EPPIC) that assessed the first-year costs and outcomes of treatment.

Method: The current study used a matched, historical control group design with a follow-up of approximately 8 years. Complete follow-up data were available for 65 of the original 102 participants. Direct public mental health service costs incurred subsequent to the first year of treatment and symptomatic and functional outcomes of 32 participants initially treated for up to 2 years at EPPIC were compared with a matched cohort of 33 participants initially treated by generic mental health services. Treatment-related resource use was measured and valued using Australian published prices.

Results: Almost 8 years after initial treatment, EPPIC subjects displayed lower levels of positive psychotic symptoms (P = .007), were more likely to be in remission (P = .008), and had a more favorable course of illness (P = .011) than the controls. Fifty-six percent of the EPPIC cohort were in paid employment over the last 2 years compared with 33% of controls (P = .083). Each EPPIC patient costs on average A$3445 per annum to treat compared with controls, who each costs A$9503 per annum.

Conclusions: Specialized early psychosis programs can deliver a higher recovery rate at one-third the cost of standard public mental health services. Residual methodological limitations and limited sample size indicate that further research is required to verify this finding.
Language eng
DOI 10.1093/schbul/sbp054
Field of Research 111714 Mental Health
140208 Health Economics
Socio Economic Objective 920209 Mental Health Services
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
HERDC collection year 2009
Copyright notice ©2009, The Author
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Document type: Journal Article
Collection: Public Health Research, Evaluation, and Policy Cluster
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