Assessing cost-effectiveness in mental health : vocational rehabilitation for schizophrenia and related conditions

Chalamat, Maturot, Mihalopoulos, Cathy, Carter, Rob and Vos, Theo 2005, Assessing cost-effectiveness in mental health : vocational rehabilitation for schizophrenia and related conditions, Australian and New Zealand journal of psychiatry, vol. 39, no. 8, pp. 693-700, doi: 10.1111/j.1440-1614.2005.01653.x.

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Title Assessing cost-effectiveness in mental health : vocational rehabilitation for schizophrenia and related conditions
Author(s) Chalamat, Maturot
Mihalopoulos, CathyORCID iD for Mihalopoulos, Cathy
Carter, RobORCID iD for Carter, Rob
Vos, Theo
Journal name Australian and New Zealand journal of psychiatry
Volume number 39
Issue number 8
Start page 693
End page 700
Publisher Wiley Interscience
Place of publication Malden, Mass.
Publication date 2005
ISSN 0004-8674
Keyword(s) cost–benefit
vocational rehabilitation
Summary Objective: Existing evidence suggests that vocational rehabilitation services, in particular individual placement and support (IPS), are effective in assisting people with schizophrenia and related conditions gain open employment. Despite this, such services are not available to all unemployed people with schizophrenia who wish to work. Existing evidence suggests that while IPS confers no clinical advantages over routine care, it does improve the proportion of people returning to employment. The objective of the current study is to investigate the net benefit of introducing IPS services into current mental health services in Australia.

: The net benefit of IPS is assessed from a health sector perspective using cost–benefit analysis. A two-stage approach is taken to the assessment of benefit. The first stage involves a quantitative analysis of the net benefit, defined as the benefits of IPS (comprising transfer payments averted, income tax accrued and individual income earned) minus the costs. The second stage involves application of 'second-filter' criteria (including equity, strength of evidence, feasibility and acceptability to stakeholders) to results. The robustness of results is tested using the multivariate probabilistic sensitivity analysis.

Results: The costs of IPS are $A10.3M (95% uncertainty interval $A7.4M–$A13.6M), the benefits are $A4.7M ($A3.1M–$A6.5M), resulting in a negative net benefit of $A5.6M ($A8.4M–$A3.4M).

Conclusions: The current analysis suggests that IPS costs are greater than the monetary benefits. However, the evidence-base of the current analysis is weak. Structural conditions surrounding welfare payments in Australia create disincentives to full-time employment for people with disabilities.
Language eng
DOI 10.1111/j.1440-1614.2005.01653.x
Field of Research 111714 Mental Health
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2006 The Authors; Journal compilation and The Royal Australian and New Zealand College of Psychiatrists
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Document type: Journal Article
Collections: Faculty of Health
School of Health and Social Development
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