Cost-effectiveness of a PTSD intervention tailored for individuals with severe mental illness

Eric Slade, Jennifer D. Gottlieb, Weili Lu, Philip T. Yanos, Stanley Rosenberg, Steven M. Silverstein, Shula K. Minsky, Kim T. Mueser

Research output: Contribution to journalArticle

Abstract

Objective: This study examined the cost-effectiveness of a cognitive-behavioral therapy (CBT) intervention for posttraumatic stress disorder (PTSD) that is tailored for adults with a co-occurring severe mental illness. Methods: Data were from a randomized trial involving 183 adult clients of two outpatient clinics and three partial hospitalization programs. All had a severe mental illness diagnosis (major mood disorder, schizophrenia, or schizoaffective disorder) and severe PTSD. Participants were randomly assigned to the tailored 12- to 16-session CBT intervention for PTSD (CBT-P) or a three-session breathing retraining and psychoeducation intervention (BRF). Cost estimates included intervention costs for training, supervision, fidelity assessment, personnel, and overhead and related mental health care costs for outpatient, inpatient, and emergency department services and for medications. The incremental cost-effectiveness ratio comparing CBT-P with BRFmeasured the added cost or savings per remission from PTSD at 12 months postintervention. Generalized linear models were used to estimate intervention effects on annual mental health care costs and the likelihood of a remission from PTSD. Ten thousand bootstrap replications were used to assess uncertainty. Results: Annual mean mental health care costs were $25,539 per client (in 2010 dollars) for BRF participants and $29,530 per client for CBT-P participants, a nonsignificant difference. The mean incremental cost-effectiveness ratio was $36,893 per additional PTSD remission yielded by CBT-P compared with BRF (95% confidence interval=2$33,523 to $158,914). Remissions were associated with improvements in quality of life and functioning. Conclusions: An effective CBT intervention tailored for adults with severemental illness and PTSD was not found to bemore cost-effective than a brief three-session intervention.

Original languageEnglish (US)
Pages (from-to)1225-1231
Number of pages7
JournalPsychiatric Services
Volume68
Issue number12
DOIs
StatePublished - Dec 1 2017
Externally publishedYes

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Post-Traumatic Stress Disorders
Cognitive Therapy
Cost-Benefit Analysis
Health Care Costs
Mental Health
Costs and Cost Analysis
Medical Day Care
Cost Savings
Ambulatory Care Facilities
Mood Disorders
Psychotic Disorders
Uncertainty
Hospital Emergency Service
Inpatients
Linear Models
Schizophrenia
Respiration
Outpatients
Quality of Life
Confidence Intervals

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Slade, E., Gottlieb, J. D., Lu, W., Yanos, P. T., Rosenberg, S., Silverstein, S. M., ... Mueser, K. T. (2017). Cost-effectiveness of a PTSD intervention tailored for individuals with severe mental illness. Psychiatric Services, 68(12), 1225-1231. https://doi.org/10.1176/appi.ps.201600474

Cost-effectiveness of a PTSD intervention tailored for individuals with severe mental illness. / Slade, Eric; Gottlieb, Jennifer D.; Lu, Weili; Yanos, Philip T.; Rosenberg, Stanley; Silverstein, Steven M.; Minsky, Shula K.; Mueser, Kim T.

In: Psychiatric Services, Vol. 68, No. 12, 01.12.2017, p. 1225-1231.

Research output: Contribution to journalArticle

Slade, E, Gottlieb, JD, Lu, W, Yanos, PT, Rosenberg, S, Silverstein, SM, Minsky, SK & Mueser, KT 2017, 'Cost-effectiveness of a PTSD intervention tailored for individuals with severe mental illness', Psychiatric Services, vol. 68, no. 12, pp. 1225-1231. https://doi.org/10.1176/appi.ps.201600474
Slade, Eric ; Gottlieb, Jennifer D. ; Lu, Weili ; Yanos, Philip T. ; Rosenberg, Stanley ; Silverstein, Steven M. ; Minsky, Shula K. ; Mueser, Kim T. / Cost-effectiveness of a PTSD intervention tailored for individuals with severe mental illness. In: Psychiatric Services. 2017 ; Vol. 68, No. 12. pp. 1225-1231.
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