Economic impact of early intervention in people at high risk of psychosis
21 October 2009
New research from the Institute of Psychiatry at King’s, published in October’s edition of Psychological Medicine, has shown that the early intervention service Outreach and Support in South London (OASIS) reduces the risk of psychosis developing and saves the NHS money.
For some time it has been national policy in the UK to implement specialist early intervention services for psychosis however their economical impact has never been studied. Considering affordability and cost-effectiveness of different interventions may be critical given the scarcity of healthcare services, particularly for new developments.
A number of new clinical services identify and manage people in the early stages of psychotic disorders which aim to intervene as soon as possible after the onset of the first episode of psychosis. However, OASIS is a service which intervenes before the first episode during what is known as the ‘at-risk’ phase of the illness. Intervention at this earlier stage has the potential to dramatically reduce the duration of untreated psychosis, as the client has already engaged with services before the onset of illness and so can access them faster.
The aim of this study was to assess the cost-effectiveness of OASIS compared with existing patterns of care called ‘care as usual’ (CAU) and gain an insight into the short term economic impact of early intervention services. The research looked at the cost of managing individuals referred to OASIS compared to the costs of CAU over a period of 2 years. Over the first 12 months from the presentation of the illness, the costs of the OASIS intervention were £1872 higher than CAU, however, after 24 months OASIS was £961 less than CAU. The study found that intervention at this earlier, high risk stage reduced the risk of some developing psychosis at all - less people went on to develop psychosis and those who did were less likely to be admitted to hospital or lose employment.
Lead author Dr Lucia Valmaggia said: 'Our evidence suggests that intervention before psychosis develops can reduce the incidence of psychosis and improve outcome in those who develop psychosis. This would have substantial cost implications for the NHS. This is the first study into early intervention services which demonstrates both clinical and economic benefits.'
Dr Valmaggia continued: 'Further research is required to monitor service use and outcome over a period of five to ten years to establish whether these preventative efforts have a long lasting effect.'
‘Economic impact of early intervention in people at high risk of psychosis’ is published in Psychological Medicine and can be accessed here: http://journals.cambridge.org/action/displayIssue?jid=PSM&volumeId=39&issueId=10&iid=6161496#
The OASIS team were shortlisted for Psychiatric Team of the Year at the inaugural Royal College of Psychiatrists Awards held at the Royal Society of Medicine this month.