clinical practice 1 - services and recovery Flashcards
why are mental health services needed (3)
reduction of suffering
- lessening distress
- improved quality of life (meaningful)
- limit risks to individual and others
social benefits
- diverse, inclusive, fair society
- lower risk to self and others
economic cost and benefits
economic benefits of providing mental health care (3)
output effects
- employment
savings to NHS
- reduced costs
- reduced referrals to secondary sector and inpatients, less medication + GP consultations
- estimated £300 over 2 years
savings to the exchequer
- increased employment
- reduced benefits and increased tax receipts
- saving on NHS costs
economic costs of mental health
costs £105bn per year in England
this is from: service provision, lost work, reduced quality of life
over £2000 per person per year in England
how many people with mental health disorders get help for it (+ implications)
1 in 3
therefore need to think whether more resources should be put into services providing help
would paying to treat more people actually save money?
healthcare costs in England
all problems = £100bn
mental health problems = £13bn
- anxiety and depression = £3.75bn
- children and adolescent MH = £0.75bn
medically unexplained symptoms = £3bn
of all health research funding, only 5% to mental health (large chunk to dementia research)
highest healthcare cost on physical health
IAPT initiative - cost-benefit trade off
cost
4 treatment results
improving access to psychological therapies
for the cost-benefit trade off of investment into treating mental health
mean resource cost for treatment course = £750
result of treatments for all patients (whether they recover or not):
- employment increase by 18%
- absence from work decrease by 31 days/year
- economic output per person rises by £1100/month
- where present, cost of comorbid physical conditions go down by thousands
therefore this has found the benefits outweighed the cost
EIP - 3 outcomes
early intervention in psychosis
seeks to reduce amount of time between onset of symptoms of psychosis (1% of population) and when they receive help
this help aims to reduce impact of symptoms on ability to work, have relationships, be in education etc.
patients receiving EIP services (vs those with non-EIP services):
- 116% more likely to gain employment
- 52% more likely to get accommodation in a mainstream house
- 17% more likely to have improvement in emotional wellbeing (on HONOS questionnaire)
what % of population will develop psychosis
around 1% - then require longer term care
EIP - cost analysis
4 services
overall cost/saving
cost differences:
- lower mental health inpatient costs (£4,075)
- lower acute hospital outpatients costs (£59)
- lower A&E costs (£31)
- higher mental health community costs (£648)
overall:
less costly health services gives a mean annual NHS cost saving associated with EIP of £4,031
overview of NHS care offered
across life span
acute or long term care
physical and mental health
provides info and evidence of practices
general practice in the NHS - % of patient interaction, % who make apt for psychological distress
90% of NHS patient interaction is with primary care services: GPs, dental, or community pharmacy services
30% of people who make an appointment with a GP do so for help with psychological distress
CAMHS
child and adolescent mental health services
refer to them by a GP
- NHS
- assesses and treats young people with emotional, behavioural, or mental health difficulties up to age 18
- most work with whole family to support them
IAPT
improving access to psychological therapies
refer to by GP ( or by direct referrals )
- provide evidence
- often 6 sessions or fewer (very short term) - this is controversial - could feel that treatment is cut short and then not given any further
- for anxiety and depression, predominantly CBT principles
- also focus on economic improvement for patients isn’t liked by some people
EIP
early intervention in psychosis
integrated service for age 14-65 presenting with first episode of psychosis
multi-disciplinary team (doctor, nurse, social worker etc.)
CMHT and ABT
community mental health team
assessment and brief treatment
provide initial assessment for signposting to other services
