Cost effectiveness of psychiatric rehabilitation

Conditions

Severe Mental Illness Mental and Behavioural Disorders

Sanches SA, Swildens WE, Schaefer B, Moerbeek M, Feenstra TL, van Asselt ADI, Danner UN, van Weeghel J, van Busschbach JT.

2020-09-239 citations

10.3389/fpsyt.2020.571640

Cost effectiveness and budgetary impact of the Boston University approach to Psychiatric Rehabilitation for societal participation in people with severe mental illness: a randomised controlled trial protocol.

Sanches SA, Swildens WE, van Busschbach JT, Stant AD, Feenstra TL, van Weeghel J.

2015-09-157 citations

10.1186/s12888-015-0593-8

Interventions

Participants will receive BPR or care-as-usual for 1 year. Boston Psychiatric Rehabilitation (BPR) uses a methodology that helps patients to explore, choose and realize their rehabili

generic mental health nurse care, social work and generic vocational rehabilitation programmes. Measurements will take place at baseline, 6 months and 12 months after enrollment.

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Having Severe Mental Illness (SMI): a diagnosis according to Diagnostic and Statistical Manual of Mental Disorders (DSM) IV, duration of service contact more than two years; GAF S-D score indicating substantial handicaps in global psychosocial functioning [Global Assessment of Functioning - Symptoms and Disabilities (GAF S-D); score 60 or lower] 2. Expressing a wish for change in societal participation (work, education, daily activities outside the home) 3. Between 18-60 years of age 4. Willing to participate in a rehabilitation process and in the research

Exclusion criteria

Exclusion criteria: 1. Legally incompetent 2. Younger than 18 years 3. Older than 60 years. We decided for the maximum age of 60 years because patients with older age usually have different goals in social participation, notably other than obtaining regular employment. 4. Received Boston Psychiatric Rehabilitation in the 4 months preceding the start of the trial 5. Admitted as inpatient to a Mental Health Care (MHC) centre

Design outcomes

Primary

Measure	Time frame
1. Increase in societal participation (getting paid work, voluntary work, and schooling (yes/no; after 6 and 12 months), measured with the Birchwood Social Functioning Scale (Birchwood et al., 1990) 2. Change in social participation expressed in terms of incremental cost per proportion increase in societal participation 3. A cost-utility analysis in terms of Quality Adjusted Life Years (QUALY)	—

Secondary

Measure	Time frame
1. Change in the number of hours of societal participation and in the position of patients on the national societal participation ladder (Divosa, www.participatieladder.nl) 2. Patients' experience of success (yes/no) in achieving societal participation goals in the areas addressed, such as work and schooling. For this purpose we developed an instrument in previous RCTs (Swildens et al., 2011) 3. Change in quality of life measured by the Manchester Quality of life Schedule (MANSA); (Priebe S, 1999) 4. Change in functioning is measured from different perspectives. First, psychosocial functioning is measured by the Birchwood Social Functioning Scale (Birchwood et al., 1990). Further change in psychosocial functioning is measured from the Mental Health Care team's perspective with the Activity and Participation scale (Van Wel et al., 2002). Further change in symptomatic functioning and psychiatric remission is measured with the (remission items) of the Brief Psychiatric Rating Scale (Ventura et al., 1993) 5. Increase of self-esteem with the Recovery Assessment Scale (Corrigan et al., 2004)	—

Measure

Time frame

1. Change in the number of hours of societal participation and in the position of patients on the national societal participation ladder (Divosa, www.participatieladder.nl) 2. Patients' experience of success (yes/no) in achieving societal participation goals in the areas addressed, such as work and schooling. For this purpose we developed an instrument in previous RCTs (Swildens et al., 2011) 3. Change in quality of life measured by the Manchester Quality of life Schedule (MANSA); (Priebe S, 1999) 4. Change in functioning is measured from different perspectives. First, psychosocial functioning is measured by the Birchwood Social Functioning Scale (Birchwood et al., 1990). Further change in psychosocial functioning is measured from the Mental Health Care team's perspective with the Activity and Participation scale (Van Wel et al., 2002). Further change in symptomatic functioning and psychiatric remission is measured with the (remission items) of the Brief Psychiatric Rating Scale (Ventura et al., 1993) 5. Increase of self-esteem with the Recovery Assessment Scale (Corrigan et al., 2004)

—

Countries

Netherlands

Outcome results

None listed