Modelling the Economic Impact of EI for Children and Adolescents

Abstract

A small number of EI services have been established for children/adolescents but evaluations are rare. This paper describes a model to assess the impact of one such service. A decision model was used to map the care pathways for children/adolescents presenting to services. Patients may have actual psychosis or they may be in an ‘at risk mental state’ (ARMS) or they may have another mental health problem. If psychosis has developed then the treatment options are to admit the patient or to provide community-based care. If the patient is in an ARMS then either psychosocial interventions, medical interventions, a combination of these or no treatment is provided. End points in the model are defi ned by recovery or non-recovery. The two parts of the model differ in the probabilities of the treatments being provided for patients in an ARMS. It is assumed that such a state will be recognised by an EI team and treatment will be provided accordingly. It is assumed that standard CAMHS will recognise fewer ARMS cases than EI services will. Data suggest that length of stay for those admitted is substantially less for those receiving EI. Costs were attached to the different services received. The results suggest cost savings of £3677, or 22%, for EI. Even though patients with ARMS are more likely to receive interventions if they are seen by an EI team the EI costs are less due to the reduced length of stay for those with psychosis who are admitted.