Early mental health care improves outcomes and reduces cost burden, study finds

Shortening treatment and waiting times for mental health conditions from 12 months to three could both reduce the cost burden on the NHS and improve treatment outcomes, a study has found.

The study, which was published in the journal Nature Mental Health, used health-economic modelling to analyse anonymised data from 27,540 people with depression and anxiety using NHS services in England. It was conducted by ieso Digital Health Ltd in partnership with Dorset HealthCare University NHS Trust and York Health Economics Consortium, which is part of the University of York.

The researchers constructed health economic models that captured the costs associated with different severities of the conditions. Analysis of the data enabled the researchers to compare the difference in costs, and the effectiveness of treatment, according to when people were treated.

They said that the “substantive costs of mental health conditions are driven by not intervening in an adequate or timely manner.”

They found that that internet-delivered cognitive behavioural therapy (CBT) had greater cost-effectiveness and similar clinical effectiveness in comparison to standard care, as well as a shorter waiting time.

The researchers calculated that there would be a future annual saving of approximately £600m on average for people with all levels of anxiety and depression severity if waiting times and treatment for mental health conditions were shortened.

Andrew Welchman, executive vice president of impact at ieso, said: “Modelling real-world healthcare data in this way allowed us to show how important it is to provide rapid access to effective mental health treatment.

“Further to this, the study has provided important insights into the key factors influencing health and economic outcomes.

“As this data was used to track individuals through their treatment in a real-world setting, it provided information on number of sessions, waiting times, treatment requirements, and engagement with treatment, which reflected true human behaviour in a clinical practice.”

Timely intervention can improve quality of life

Sam Harper, a research consultant at York Health Economics Consortium, said that the report findings might “assist those in charge of commissioning services in this area.”

He added: “Whilst comparing online therapy to standard care, the results of our study indicates that the right therapy delivered in a timely manner can increase quality of life and reduce costs for people by utilising real, anonymised patient data to examine how people’s treatment outcomes are related to the therapy they received. These results are predominantly driven by a reduced need for costly resources that are traditionally required.”

Historically, most studies evaluating the costs of mental health care have focused on generalised anxiety and major depression, but have not investigated the cost-effectiveness for different treatment methods for these conditions

Shortening treatment and waiting time could have dual benefits, Harper said: “The right therapy delivered in a timely manner can increase quality of life for people and reduce costs to the NHS by utilising real, anonymised patient data to examine how people’s treatment outcomes are related to the therapy they received.”

One of the research partners, ieso, is now focusing on developing scalable digital solutions that combine human care and computer-delivered therapy.

The idea is that these solutions could extend the reach of individual therapists, helping to deliver faster access to care to people with mental health problems.

The researchers acknowledge, however, that more research is needed to understand services in different parts of the UK to reach a fuller picture of cost-effectiveness.