scholarly journals Community interventions for people with complex emotional needs that meet the criteria for personality disorder diagnoses: systematic review of economic evaluations and expert commentary

BJPsych Open ◽  
2021 ◽  
Vol 7 (6) ◽  
Author(s):  
Joe Botham ◽  
Amy Clark ◽  
Thomas Steare ◽  
Ruth Stuart ◽  
Sian Oram ◽  
...  
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Cost Effective ◽  
Economic Evaluations ◽  
Economic Evidence ◽  
Emotional Needs ◽  
Community Based Interventions ◽  
Community Based ◽  
Single Intervention ◽  
The Cost

Background Diagnoses of personality disorder are prevalent among people using community secondary mental health services. Identifying cost-effective community-based interventions is important when working with finite resources. Aims To assess the cost-effectiveness of primary or secondary care community-based interventions for people with complex emotional needs who meet criteria for a diagnosis of personality disorder to inform healthcare policy-making. Method Systematic review (PROSPERO: CRD42020134068) of databases. We included economic evaluations of interventions for adults with complex emotional needs associated with a diagnosis of personality disorder in community mental health settings published before 18 September 2019. Study quality was assessed using the CHEERS statement. Results Eighteen studies were included. The studies mainly evaluated psychotherapeutic interventions. Studies were also identified that evaluated altering the setting in which care was delivered and joint crisis plans. No strong economic evidence to support a single intervention or model of community-based care was identified. Conclusions Robust economic evidence to support a single intervention or model of community-based care for people with complex emotional needs is lacking. The strongest evidence was for dialectical behaviour therapy, with all three identified studies indicating that it is likely to be cost-effective in community settings compared with treatment as usual. More robust evidence is required on the cost-effectiveness of community-based interventions on which decision makers can confidently base guidelines or allocate resources. The evidence should be based on consistent measures of costs and outcomes with sufficient sample sizes to demonstrate impacts on these.

scholarly journals Community interventions for people with complex emotional needs that meet the criteria for ‘personality disorder’ diagnoses: a systematic review of economic evaluations

2020 ◽  
Author(s):  
Joe Botham ◽  
Amy Clark ◽  
Thomas Steare ◽  
Ruth Stuart ◽  
Sian Oram ◽  
...  
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Personality Disorder ◽  
Economic Evaluations ◽  
Economic Evidence ◽  
Emotional Needs ◽  
Community Based Interventions ◽  
Community Based ◽  
Single Intervention ◽  
The Cost

AbstractBackgroundDiagnoses of “personality disorder” are prevalent among people using community secondary mental health services. Whilst the effectiveness of a range of community-based treatments have been considered, as the NHS budget is finite, it is also important to consider the cost-effectiveness of those interventions.AimsTo assess the cost-effectiveness of primary or secondary care community-based interventions for people with complex emotional needs that meet criteria for a diagnosis of “personality disorder” to inform healthcare policy making.MethodSystematic review (PRESPORO #: CRD42020134068) of five databases, supplemented by reference list screening and citation tracking of included papers. We included economic evaluations of interventions for adults with complex emotional needs associated with a diagnosis of ‘personality disorder’ in community mental health settings published between before 18 September 2019. Study quality was assessed using the CHEERS statement. Narrative synthesis was used to summarise study findings.ResultsEighteen studies were included. The studies mainly evaluated psychotherapeutic interventions. Studies were also identified which evaluated altering the setting in which care was delivered and joint crisis plans. No strong economic evidence to support a single intervention or model of community-based care was identified.ConclusionThere is no robust economic evidence to support a single intervention or model of community-based care for people with complex emotional needs. The review identified the strongest evidence for Dialectical Behavioural Therapy with all three identified studies indicating the intervention is likely to be cost-effective in community settings compared to treatment as usual. Further research is needed to provide robust evidence on the cost-effectiveness of community-based interventions upon which decision makers can confidently base guidelines or allocate resources.

Mental Health Outcomes of Peer-led Therapeutic Adventure for Military Veterans

2021 ◽  
pp. 105382592110495
Author(s):  
Joanna Ellen Bettmann ◽  
Ileana Anderson ◽  
Joe Makouske ◽  
Adam Hanley
Keyword(s):  
Mental Health ◽  
Military Veterans ◽  
Well Being ◽  
Group Model ◽  
Health Issues ◽  
Post Traumatic Stress ◽  
Community Based Interventions ◽  
Community Based ◽  
Post Traumatic ◽  
Adventure Program

Background: Skepticism of therapy and stigma are significant barriers for veterans with mental health issues. Therapeutic adventure shows promise in addressing veterans’ mental health needs while circumventing the stigma many veterans face in initiating treatment. Purpose: Given the small group model of therapeutic adventure programs, such programs may be ideal to provide social support for veterans and reduce mental health symptomology. The present study investigated: can a brief peer-led therapeutic adventure program modify veterans’ mental health symptoms? Methodology/Approach: The study's sample included 56 participants attending one Sierra Club Military Outdoors trip lasting at least three days and two nights and involving camping. Participants completed study measurements assessing depression, anxiety, stress, Post-Traumatic Stress Disorder symptoms, substance misuse symptoms, and suicidality at pre-trip, post-trip, one-month post trip, six-months post trip, and 12-months post trip. Six-month and 12-month post-trip data was collected during the COVID-19 pandemic. Findings/Conclusions: Results indicated significant reduction in mental health symptomology from pre-trip to post-trip, but showed few longer-term changes in mental health symptomology. Implications: The present study's findings are consistent with research suggesting improvements in overall psychological well-being immediately following a nature-based intervention and suggest the need for on-going, community-based interventions to support optimally military veterans’ mental health.

A community-based approach to evaluation of health outcomes and costs for telepsychiatry in a rural population: Preliminary results

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 155-157 ◽  
Author(s):  
Craig Kennedy ◽  
Peter Yellowlees
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Rural Areas ◽  
Pilot Trial ◽  
Public Mental Health ◽  
Cost Effective ◽  
Community Based ◽  
Public And Private ◽  
Preliminary Results ◽  
The People

A pilot trial was established to support visiting psychiatric services and local public and private practitioners through the use of videoconferencing. The purpose of the trial was to determine whether people in the community received better health-care with telemedicine. A community-based approach was used to evaluate health outcomes, costs, utilization, accessibility, quality and needs for such services in a rural community in Queensland. Over a two-year period data were collected from 124 subjects who met the criteria of having a mental health problem or mental disorder. Nine further subjects refused to participate in the study. Only 32 subjects used videoconferencing to receive mental health services. Preliminary results did not show any significant improvements in wellbeing or quality of life, although the time span was relatively short. However, the results confirmed that the people were no worse off from a consumer or a practitioner perspective from using videoconferencing. Most consumers found that videoconferencing with a psychiatrist moderately or greatly helped them in managing their treatment, with 98% of them preferring to be offered videoconferencing in combination with local services. Overall, videoconferencing is a crucial part of enhancing psychiatry services in rural areas. However, it is not necessarily cost-effective for all consumers, general practitioners, psychiatrists, or the public mental health service.

scholarly journals Health Care and Community-based Interventions for War-traumatized People in Croatia: Community-based Study of Service Use and Mental Health

2008 ◽  
Vol 49 (4) ◽  
pp. 483-490 ◽  
Author(s):  
Tanja Frančišković ◽  
Zdravko Tovilović ◽  
Zoran Šuković ◽  
Aleksandra Stevanović ◽  
Dean Ajduković ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Service Use ◽  
Community Based Interventions ◽  
Community Based

scholarly journals The economics of mental health in the workplace: what do we know and where do we go?

2007 ◽  
Vol 16 (4) ◽  
pp. 294-298 ◽  
Author(s):  
David McDaid
Keyword(s):  
Mental Health ◽  
Grey Literature ◽  
Cost Effective ◽  
Evidence Base ◽  
Poor Mental Health ◽  
Health Interventions ◽  
Economic Evaluations ◽  
Policy Makers ◽  
Productivity Losses ◽  
Mental Health Interventions

AbstractTo provide an overview of the economic impact of poor mental health in the workplace and assess the extent to which economic evaluation has been used to further the case for investment in workplace based mental health programmes. Rapid scoping review of published and grey literature. The socio-economic costs of poor mental health in the workplace are substantial but conservative, as few studies have included productivity losses from work cutback, as well as absenteeism. While few economic evaluations of workplace based mental health interventions were identified, the available evidence base suggests that they have the potential to be highly cost effective. Much of this evidence may be from the US and be less applicable elsewhere; it may also have been solely published in company documents making assessment of methodological quality difficult. The potential economic case for workplace based mental health interventions appears good. More collaboration between policy makers and the private sector would help facilitate rigorous and transparent economic evaluations. A number of evaluations are planned. The challenge is to build on these initiatives, in order to address what remains a major gap in our knowledge on the economics of mental health.

Psychological Science Into Practice During the COVID-19 Pandemic

2021 ◽  
Vol 26 (4) ◽  
pp. 387-396
Author(s):  
Eleni Karayianni ◽  
Tom Van Daele ◽  
Jasminka Despot-Lučanin ◽  
Josip Lopižić ◽  
Nicholas Carr
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Professional Growth ◽  
European Federation ◽  
Evidence Based ◽  
Community Based Interventions ◽  
Community Based ◽  
The Public ◽  
The Third ◽  
Psychological Science

Abstract. The public health outbreak of the COVID-19 virus has hit all aspects of life as we know it. We found ourselves trying to solve several concurrent crises that have afflicted us. The European Federation of Psychologists’ Associations (EFPA) launched the Psychologists’ Support Hub to share resources among its members and beyond and promote the continuing adoption of psychological science to battle the pandemic. In the greater context of evidence-based practice (EBP), the best available evidence is what we turn to for help in our decision-making on how best to address different challenges. However, there are challenges in implementing EBP when the science is limited, and we are still expected to be effective and efficient as professionals. The article outlines the need for EBP during the pandemic. Three vignettes display how that can be done while identifying obstacles and recommending ways forward in the future. The first one relates to the development of e-mental health services in Belgium following the March 2020 lockdown. The second describes addressing the needs of older adults in Croatia when it was hit by two crises simultaneously – the March 2020 lockdown and a destructive earthquake. The third looks at how targeted community-based interventions in Norway directed at social change can positively impact times of crisis. Overall, the pandemic presents a unique opportunity for professional growth for researchers, trainers, practitioners, and policymakers alike. EFPA can play a pivotal role in EBP adoption.

School and Community - based Youth Mental Health Intervention Studies in India: A Scoping Review

2019 ◽  
Vol 2 (02) ◽  
pp. 14-22
Author(s):  
Ragaviveka Gopalan ◽  
C Sangeetha ◽  
P Ramakrishnan ◽  
Vijaya Raghavan
Keyword(s):  
Mental Health ◽  
Young People ◽  
Mental Disorders ◽  
Youth Mental Health ◽  
Health Interventions ◽  
Community Based Interventions ◽  
Community Based ◽  
School Based ◽  
School And Community ◽  
Mental Health Interventions

BACKGROUND About 70% of mental disorders emerge in late childhood and young peo-ple bear the burden of these disorders throughout life. Yet, to date there has been com-paratively little research on mental health interventions for young people in India and not many attempts have been made to collate the existing literature. This systematic review aims to synthesize the available evidence on school- and community-based mental health interventions for young people in India. METHODS A range of major electronic databases were searched systematically, and the abstracts of relevant papers were independently examined for possible inclusion. Selected papers were read in full text and a standardized set of data items were extracted. RESULTS Four papers met inclusion criteria for the analysis; two studies of school-based interventions for adolescents and two studies evaluating out-of-school community interventions for youth were reviewed. The quality of evidence from the interventions in Indian school and community settings were poor. While two studies evidence the effectiveness of a school-based life skills programme and a community based multicomponent intervention designed to promote youth health, two other studies do not offer sufficient data. CONCLUSION The review findings indicate that the number of interventional studies conducted in India to address youth mental health issues are very limited. Hence, it is extremely difficult to ensure the feasibility and effectiveness of school and community-based interventions in India. Further research is warranted to establish whether interventions promoting youth mental health people can be implemented effectively in Indian settings with positive mental health outcomes. Given the possibility of a huge population of young people at-risk or experiencing mental disorders, evidence for the efficacy of youth mental health interventions is crucial.

scholarly journals Guide to cost benefit analysis of community-based interventions

2014 ◽  
Vol 3 (5) ◽  
pp. 47
Author(s):  
Sanni Yaya ◽  
Xiaonan Li
Keyword(s):  
Net Present Value ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Ratio ◽  
Benefit Analysis ◽  
Costs And Benefits ◽  
Community Based Interventions ◽  
Community Based ◽  
Benefit Cost Ratio ◽  
The Cost

This paper offers a general guide on how to conduct a proper economic analysis for community-based intervention projects. Identification and quantification of costs and benefits are the focus of the cost benefit analysis. We categorize costs and benefits from human and physical perspectives and pay special attention to the measures of saving human lives accompanied by the proposed calculation methods. We recommend net present value and benefit-cost ratio as the criteria to assess projects and highlight some challenges remaining in the analysis.

scholarly journals TECHNIQUES FOR DIAGNOSING OSTEOPOROSIS: A SYSTEMATIC REVIEW OF COST-EFFECTIVENESS STUDIES

2014 ◽  
Vol 30 (3) ◽  
pp. 273-281 ◽  
Author(s):  
Davide Minniti ◽  
Ottavio Davini ◽  
Maria Rosaria Gualano ◽  
Maria Michela Gianino
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Postmenopausal Women ◽  
Cost Effective ◽  
Economic Evaluations ◽  
Clear Cut ◽  
Step Procedure ◽  
Database Research ◽  
The Cost ◽  
Effectiveness Studies

Objectives:The study question was whether dual-energy X-ray absorptiometry (DXA) alone is more cost-effective for identifying postmenopausal women with osteoporosis than a two-step procedure with quantitative ultrasound sonography (QUS) plus DXA. To answer this question, a systematic review was performed.Methods:Electronic databases (PubMed, INAHTA, Health Evidence Network, NIHR, the Health Technology Assessment program, the NHS Economic Evaluation Database, Research Papers in Economics, Web of Science, Scopus, and EconLit) were searched for cost-effectiveness publications. Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Quality assessment of economic evaluations was undertaken using the Drummond checklist.Results:Seven journal articles and four reports were reviewed. The cost per true positive case diagnosed by DXA was found to be higher than that for diagnosis by QUS+DXA in two articles. In one article it was found to be lower. In three studies, the results were not conclusive. These articles were characterized by the differences in the types of devices, parameters and thresholds on the QUS and DXA tests and the unit costs of the DXA and QUS tests as well as by variability in the sensitivity and specificity of the techniques and the prevalence of osteoporosis.Conclusions:The publications reviewed did not provide clear-cut evidence for drawing conclusions about which screening test may be more cost-effective for identifying postmenopausal women with osteoporosis.

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