Identifying attributes of care that may improve cost‐effectiveness in the youth mental health service system

Hamilton, Matthew; Hetrick, Sarah; Mihalopoulos, Cathrine; Baker, David; Browne, Vivienne; Chanen, Andrew M; Pennell, Kerryn; Purcell, Rosemary; Stavely, Heather; McGorry, Patrick D.

doi:10.5694/mja17.00972

Cited by 25 publications

(28 citation statements)

References 136 publications

(133 reference statements)

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“…Progress in economic evidence development in this area remains slow. More evidence is available on psychosis early intervention, which often also covers an adult population and is reviewed later in this paper.…”

Section: Current Economic Evidence and Key Events In Mental Health Carementioning

confidence: 99%

“…A recent literature review of economic evaluations published between 1997 and 2014 in the UK National Health Service (NHS) Economic Evaluations Database and other sources focused on attributes of care systems (i.e., excluding pharmacological or individual psychological therapies). Forty studies with both costs and outcomes of youth mental health care were identified. These interventions targeted a wide range of mental health problems, including anxiety, depression, eating disorders, psychosis, substance use disorders, unspecified mental health problems, forensic mental health, and suicide and self‐harm.…”

Section: Current Economic Evidence and Key Events In Mental Health Carementioning

confidence: 99%

“…Common attributes of interventions with favourable economic evidence were timely assessment strategies (including screening) and family‐based interventions, although for the latter some variations existed as to whether there were other more cost‐effective alternatives. Methodological problems in the literature were highlighted, including a narrow evaluation perspective, with none of the reviewed studies taking both a societal and a health care perspective.…”

Section: Current Economic Evidence and Key Events In Mental Health Carementioning

confidence: 99%

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Economics and mental health: the current scenario

2020

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Economics and mental health are intertwined. Apart from the accumulating evidence of the huge economic impacts of mental ill‐health, and the growing recognition of the effects that economic circumstances can exert on mental health, governments and other budget‐holders are putting increasing emphasis on economic data to support their decisions. Here we consider how economic evaluation (including cost‐effectiveness analysis, cost‐utility analysis and related techniques) can contribute evidence to inform the development of mental health policy strategies, and to identify some consequences at the treatment or care level that are of relevance to service providers and funding bodies. We provide an update and reflection on economic evidence relating to mental health using a lifespan perspective, analyzing costs and outcomes to shed light on a range of pressing issues. The past 30 years have witnessed a rapid growth in mental health economics, but major knowledge gaps remain. Across the lifespan, clearer evidence exists in the areas of perinatal depression identification‐plus‐treatment; risk‐reduction of mental health problems in childhood and adolescence; scaling up treatment, particularly psychotherapy, for depression; community‐based early intervention and employment support for psychosis; and cognitive stimulation and multicomponent carer interventions for dementia. From this discussion, we pull out the main challenges that are faced when trying to take evidence from research and translating it into policy or practice recommendations, and from there to actual implementation in terms of better treatment and care.

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Section: Current Economic Evidence and Key Events In Mental Health Carementioning

confidence: 99%

Section: Current Economic Evidence and Key Events In Mental Health Carementioning

confidence: 99%

Section: Current Economic Evidence and Key Events In Mental Health Carementioning

confidence: 99%

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Economics and mental health: the current scenario

2020

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“…Holistic and timely assessment has been identified as an important and potentially cost‐effective attribute of youth mental health services (Hamilton et al, ). Neurocognitive and symptom assessment specifically, is internationally recognised as important to youth mental health care (Hamilton et al, ).…”

Section: Introductionmentioning

confidence: 99%

Need for clinical neuropsychological assessment in headspace youth mental health services: A national survey of providers

Allott

van‐der‐EL

Bryce

et al. 2019

Australian Journal of Psychology

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Objective: To determine the perceived met and unmet need for clinical neuropsychological assessment (CNA) in headspace youth mental health services Australia wide. Method: Brief online survey of headspace service providers exploring the number and types of clients seen, confidence in identifying neurocognitive impairments, and need, availability and usefulness of CNA. A total of 532 salaried, private, and in-kind service providers working across 103 primary headspace and headspace Youth Early Psychosis Programs completed the survey from May to December 2017. Results: Survey respondents were 76% female with a mean age of 38 (range 22-74 years). The majority had psychology (42%) or social work (21%) backgrounds. CNA was believed to be beneficial for 35% of headspace clients on average, but 86% of service providers reported that CNA was unavailable. Only 12% of clients were estimated to have received CNA when it was needed. On average, 36% of headspace clients were estimated to present with neurocognitive impairment and 38% were described as diagnostically complex (e.g., comorbid medical, developmental, substance use, trauma presentations). A mean of 27% were described as having a suspected or diagnosed developmental condition (e.g., intellectual disability, learning disorder, autism spectrum disorder, attentiondeficit/hyperactivity disorder). Respondents rated their confidence in identifying cognitive impairment as moderate. Conclusions: There is marked unmet need for CNA to provide diagnostic clarification and inform treatment approaches in youth mental health care. Funding for CNA under the Medicare Benefits Schedule, headspace workforce development in neurocognitive screening and cognitive interventions, and tele-neuropsychological services should be explored.

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“…These att ributes were selected from a longer list identifi ed by a literature review. 18 We based our decisions about which of the att ributes identifi ed in that review to include in the fi nal survey instrument on our subjective judgements regarding where clinician opinion had the most potential to add to existing evidence. For example, acute inpatient care was one of the options identifi ed in the review for implementing crisis support, but we did not explore this in our survey as we felt that health service use data on presentations to acute services would likely provide a bett er guide to the level of need for these services.…”

Section: Methodsmentioning

confidence: 99%

Targeting mental health care attributes by diagnosis and clinical stage: the views of youth mental health clinicians

Hamilton

Hetrick

Mihalopoulos

et al. 2017

Medical Journal of Australia

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A combination of clinical stage and disorder information might be an appropriate basis for ensuring that the right attributes of early intervention mental health care are provided to the right young people at the right time. Policy and research priorities include trialling novel services, preferences research among young people, strengthening service responses to subthreshold disorders and promoting high-fidelity collection of clinical stage data in youth mental health settings.

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Identifying attributes of care that may improve cost‐effectiveness in the youth mental health service system

Cited by 25 publications

References 136 publications

Economics and mental health: the current scenario

Economics and mental health: the current scenario

Need for clinical neuropsychological assessment in headspace youth mental health services: A national survey of providers

Targeting mental health care attributes by diagnosis and clinical stage: the views of youth mental health clinicians

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