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A CLAHRC Oxford and Oxford AHSN study led by our Early Intervention theme lead and Deputy Director, Professor Belinda Lennox, has shown how early community intervention to tackle psychosis paves the way to shave £63 million off the societal costs of the illness.

Boy at sunrise for adolescent mental health blog post

The study, published in the British Medical Journal Open, calculated that if these early intervention services were rolled out across the country, the NHS alone would save £33.5 million each year.

Researchers from across the Thames Valley found that compared to those not offered early intervention services, those offered the early intervention in psychosis services  already cost the NHS around £4031 less per person, each year.

Professor Belinda Lennox, study lead and consultant psychiatrist in the early intervention services at Oxford Health NHS Foundation Trust, said: “Early Intervention Services are recommended in the NHS because of evidence gathered and analysed in a research setting that shows that these services improve outcomes for patients and save money.”

“We have now shown that each person treated in an early intervention service is twice as likely to become employed and 50% more likely to go into stable housing, compared to people with early psychosis who are treated in other services.”

“People in early intervention services also spend less time in hospital, which is good news for them, and also saves the NHS money.”

Targets set in the new ‘access and waiting times’ were introduced on 1 April 2016 for Early Intervention in Psychosis: they are the first of their kind in mental health services. The mandatory timescale has been launched to pioneer timely access to evidence-based treatments for those experiencing symptoms of mental health disorders. This policy places serious mental illness on a par with other serious medical conditions.

Psychosis is a mental health problem that causes people to perceive or interpret things differently from those around them: this might involve hallucinations, where a person perceives things which aren’t there (such as hearing voices), or delusions, where a person believes things that when examined rationally are obviously untrue (such as believing that their neighbours are plotting to kill them).

The early intervention services that we and others offer for this condition are based in the community rather than hospitals: the multidisciplinary team in charge of this service reaches out to young people who might be having a first episode of psychosis. The team works intensively with those affected, offering them as well as their family therapy and support, and meeting them as often as needed to avert crises which might otherwise have led to hospital admissions.

The team also has close links with employment and education services, to help promote recovery from psychosis.

To find out what effect these services had, a team of researchers led by Professor Lennox studied anonymised patient records from a large region across the Thames Valley, for a three year period from 2010-2013.

The research team found that compared to those not offered early intervention services, those offered the early intervention in psychosis services cost the NHS around £4031 less per person, each year.

A statistical analysis exploring the impact of providing these services across England to all adults experiencing the first episode of psychosis found an estimated £63.3 million savings in cost to society as a whole, because people offered these services were more likely to be employed and live in mainstream rather than supported housing. For the NHS alone, the savings would be £33.5 million.

Professor Lennox, who is also affiliated with the Department of Psychiatry at the University of Oxford, said: “Early intervention services improve outcomes for people with psychosis: we can demonstrate that in the NHS in our region, we are helping people with serious mental illness recover, get back to work or education, and  get on with their lives.”

“Access to these early intervention services is now mandated for everyone across England with a first episode of psychosis, regardless of age or location, as part of the first ‘access and waiting time’ standard for mental health in the NHS.”

The study was funded by the National Institute of Health Research Collaboration for Leadership in the Applied Health Research and Care (NIHR CLAHRC) Oxford at the Oxford Health NHS Foundation Trust, and the Oxford Academic Health Science Network (AHSN). It studied the region covered by the AHSN, which includes Berkshire, Buckinghamshire, Milton Keynes and Oxfordshire. Care to the 3.3 million people living in this region is provided by a number of different NHS providers, including Oxford Health NHS Foundation Trust.

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