The Cost-Effectiveness of the Improving Access to Psychological Therapies (IAPT) Programme in Severe Mental Illness: A Decision Analytical Model Using Routine Data

TY - JOUR

T1 - The Cost-Effectiveness of the Improving Access to Psychological Therapies (IAPT) Programme in Severe Mental Illness: A Decision Analytical Model Using Routine Data

AU - Zala, Darshan

AU - Brabban, Alison

AU - Stirzaker, Alex

AU - Radhakrishnan Kartha, Muralikrishnan

AU - McCrone, Paul Richard

PY - 2019/7/1

Y1 - 2019/7/1

N2 - This is the first site level economic evaluation of the Improving Access to Psychological Therapies programme for severe mental illness (IAPT-SMI) that is funded by NHS England. It also aims to illustrate the challenges involved in evaluations based on routine data with low internal validity. Six IAPT-SMI pilot sites treated 1 of 2 clinical groups: (i) psychosis or bipolar disorder; (ii) personality disorder. A decision analytical model nested in a before-after framework- the same patients 12 months after treatment versus 12 months before treatment—was used to compare the cost-effectiveness of IAPT-SMI with treatment as usual (TAU). IAPT-SMI appears to be more costly overall but save non-psychological treatment costs. There is evidence it may improve function and lower incidence of harmful behaviour. However, there is a need for evaluations with a more conventional study design that measure a more comprehensive array of resource use and clinical outcomes.

AB - This is the first site level economic evaluation of the Improving Access to Psychological Therapies programme for severe mental illness (IAPT-SMI) that is funded by NHS England. It also aims to illustrate the challenges involved in evaluations based on routine data with low internal validity. Six IAPT-SMI pilot sites treated 1 of 2 clinical groups: (i) psychosis or bipolar disorder; (ii) personality disorder. A decision analytical model nested in a before-after framework- the same patients 12 months after treatment versus 12 months before treatment—was used to compare the cost-effectiveness of IAPT-SMI with treatment as usual (TAU). IAPT-SMI appears to be more costly overall but save non-psychological treatment costs. There is evidence it may improve function and lower incidence of harmful behaviour. However, there is a need for evaluations with a more conventional study design that measure a more comprehensive array of resource use and clinical outcomes.

KW - Cost-effectiveness

KW - Economic evaluation

KW - IAPT

KW - Improving access to psychological therapies

KW - Severe mental illness

UR - http://www.scopus.com/inward/record.url?scp=85062770467&partnerID=8YFLogxK

U2 - 10.1007/s10597-019-00390-z

DO - 10.1007/s10597-019-00390-z

M3 - Article

SN - 0010-3853

VL - 55

SP - 873

EP - 883

JO - Community Mental Health Journal

JF - Community Mental Health Journal

IS - 5

ER -