Caragh Behan1,2, Eric Roche1,2, Sarah Masterson1, Laoise Renwick3, Catherine McDonough4, Brendan Kennelly5, Paul McCrone6, Mary Clarke1,7; 1DETECT, 2Cluain Mhuire Community Mental Health Services, 3School of Nursing, University of Manchester, 4Louth Mental health Services, 5Department of Economics, NUI Galway, 6King's Health Economics, London, 7University College Dublin
The economic cost of schizophrenia in Ireland was estimated to be over €461 million in 2006, with the bulk of these costs located in the labour market due to lost employment, and lost productivity. Early intervention in psychosis (EIP) aims to reduce the proportion of people not in education or employment or further training to levels no more than peer population rates. Methods An incidence based cohort of people with first episode psychosis was followed up at one year (n=205). One cohort received EI; the other received best practice TAU. Joint costs and effects were examined using the net benefit approach. The value of lost productivity was calculated using the human capital approach. The incremental net benefit (INB) to society of avoiding a relapse and of a healthy day at home (HDAH), and the differences in the proportions in education and employment were calculated. Results The value of lost productivity was €32,706 more in the TAU sample (p<0.001). More people entered employment in the EI cohort. The INB to society was €14,282 (SE €10,364), and this was robust to sensitivity analysis. Conclusion EI has a societal benefit that is captured when examining outcomes outside the health sector. Funding for mental health comes from the health budget, but benefits can accrue to sectors outside health. Examining the effects of interventions outside of the health service can show where these benefits accrue, and inform where funders and policy makers can collaborate to look outside the health budget for funding.
