Early intervention in psychosis and at risk mental state: A south london case study

LewishamThis factsheet, authored by Dr Jonathan Campion, highlights the economic case for Early Intervention in Psychosis and At Risk Mental State (ARMS) based on a case study in Lambeth, Southwark and Lewisham.

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Key messages

  • Early intervention services for first episode psychosis have clinically important benefits over standard care (Bird et al, 2011).
  • Early intervention during the phase preceding psychosis (prodrome) can prevent a proportion of psychosis from developing (Fusar-Poli et al, 2012).
  • Work by the London School of Economics for the mental health stategy highlighted the economic savings of early treatment of psychosis and prodrome psychosis (DH, 2011).
  • Across four south London boroughs, 86% of those with first episode psychosis receive treatment from early intervention psychosis services while 4% of those with prodrome psychosis receive intervention (Campion and Costafreda, 2012).

Applying the London School of Economics figures (DH, 2011) to south London, treatment of all new cases of first episode psychosis in a single year in four south London boroughs would result in:

  • Total net savings of £1,975,734 at end of first year compared with standard care due to reduced service costs.
  • Total annual net savings of £1,632,708 from years 2-5 (£823,536 due to reduced service costs and £701,784 due to reduced lost productivity).
  • Total annual net savings of £889,200 from years 6-10 (£20,520 due to reduced service costs, £653,904 due to reduced lost productivity, and £214,776 due to reduced intangible costs of associated negative impact on quality of life, reduced suicides and homicide.
  • Total savings over 10 years of treating all those with first episode psychosis in a single year would be £12,952,566 with £5,372,478 of the savings being realised by the NHS.

Applying LSE figures (DH, 2011), treatment of all new cases of psychosis prodrome (ARMS) in a single year in four south London boroughs would result in:

  • Total extra costs of £1,904,940 in the first year (due to increased service costs).
  • Total annual net savings of £2,583,810 in years 2-5 (£982,395 due to reduced service costs and £1,568,925 due to reduced lost productivity).
  • Total annual net savings of £2,226,420 in year 6-10 (£900,315 due to reduced service costs and £1,261,980 due to reduced lost productivity).
  • Total net savings of treating all those with ARMS in a single year in four south London boroughs would be £19,562,400 over 10 years with £6,526,215 of the savings realised by the NHS.