Long-Term Effectiveness and Economic Evaluation of the First Episode Mood and Anxiety Program (FEMAP)
Mental Health and Geriatric Care
We investigated the long-term therapeutic- and cost-effectiveness of early intervention for mood and anxiety disorders (with/without addictions). This research shows that early intervention for 16-25 year olds with mood/anxiety concerns is effective for long-term reduction in symptoms and improvement in functioning as well as life satisfaction. This work also shows that the cost of the service is much less than that of comparison outcomes. The model could easily be scaled up and incorporated into Integrated Youth Services that integrate ambulatory hospital with community social and mental health care services to more effectively provide treatment for youth and emerging adults. This would prevent considerable chronic mental illness and greatly reduce health care costs of mental health care.
Interest in FEMAP is growing as a model to be included in mental health care programs for youth. This work extended our 4-month follow-up study to evaluate long-term outcomes for the youth treated at FEMAP. The first objective was to evaluate treatment effectiveness of FEMAP at 1+ year follow-up. Evaluations included: reduction in symptoms, functional improvement, and satisfaction with care. The second objective was to conduct a detailed economic evaluation of FEMAP, which included an estimate of the cost of the Program, an estimate of health and social service cost by the FEMAP population with and without FEMAP care and the creation of a mathematical decision model representing mood/anxiety disorders in transition age youth integrating the trajectory of costs and health consequences under the two scenarios. This estimated the Incremental Cost-Effectiveness Ratio (ICER) of FEMAP compared to usual care. This study involved contacting all patients whom we treated over 1 year ago and collecting measures of symptom severity, function, satisfaction and interim care. The formula for the ICER was as follows: (Cost Program A-Cost Program B)/(Health Effects Program A-Health Effects Program B). Data analysis, to date, show that severity of anxiety and depressive symptoms continued to improve significantly in the patients over time, even when they were no longer in active treatment. Functional impairment and quality of life also continued to show significant improvement at 1+ year follow-up. At the time of this writing, the economic analyses are not complete, but preliminary analyses illustrated that the cost comparison of the Program was excellent with 4 months of treatment costing less than one visit to the Emergency Department on Form 1 of the Mental Health act. Economic analyses are expected to be complete by fall, 2016.