Reducing Health Care Cost by Investing in Holistic Interventions

The UK’s failure to provide adequate mental health care is costing us nearly £17 billion per year in late interventions. Apart from the escalated medical expense of treating acute and chronic conditions compared to the cost of early interventions, untreated mental illness snowballs into a costly affair across the public sector.

The cost of late mental health intervention

The Early Intervention Foundation provides us with the following itemised bill for late interventions:

  • Children’s social care: £6.2 billion (37%)
  • Crime and antisocial behaviour: £5.9 billion (35%)
  • Youth economic activity: £2.7 billion (16%)
  • Child injuries and mental health: £770 million (5%)
  • School absence and exclusion: £660 million (4%)
  • Youth substance misuse: £440 million (3%)

The cost of late intervention is distributed across different areas of the public sector, with the largest shares of the bill picked up by:

  • Local authorities: £6.4 billion
  • The NHS: £3.7 billion
  • DWP: £2.7 billion

Case study: a holistic approach to preventative mental health care reduces unscheduled treatment by 90%

While early intervention projects take a long-term view on improving health outcomes, case studies from across the UK illustrate that they can be surprisingly simple to implement and quick to show results.

The 2015 Clinical Commissioners’ report, Local Solutions to National Challenges, tells of one such scenario set in 2011/12. Concerned with the increasingly large sums spent on unscheduled care (£86 million at that point), Blackpool CCG and Fylde and Wyre CCG embarked on a fact-finding mission. Their research revealed the following:

  • A large portion of the healthcare services delivered could be attributed to the needs of a rather small number of patients.
  • In one under-serviced area, the top 100 callers to the North West Ambulance Service rang 1,100 times over a three-month period.

As an experiment in preventative care, the commissioning groups launched a combined campaign focused on the top users of unscheduled care. Frequent callers to the emergency services were phoned and asked about their various health problems. In many cases, seemingly unrelated conditions like anxiety, depression, loneliness, and self-harm were mentioned. Where appropriate, people with a need for mental health support were given immediate access to local services.

And there it is: when their emotional and social needs were met, the patients’ medical problems tended to disappear.

The project resulted in the following wins for the communities:

  • 999 calls down by 89%
  • A&E attendances down by 93%
  • hospital admissions down by 82%
  • incidences of self-harm down by 98%
  • savings of £2,757,380

Download your copy of ‘The Tales of Three Young British People’ for more case studies comparing the outcomes of early and late interventions.

The long-term economic case for investing in holistic early interventions

While scenarios like the one above illustrate the immediate savings to be won by early intervention projects, the long-term benefits make the case for this approach even more compelling. Studies on the long-term economic benefits of promoting the mental health and wellbeing of children promise lucrative outcomes:

  • In the United States, the implementation of nurse home visiting programmes for new mothers have shown a long-term return on investment of between €2 and €5 for every €1 spent.
  • In the UK, programmes involving parenting initiatives and social/emotional support for children have been estimated to have a return on investment of up to €8 for every €1 spent.
  • Most of the benefits of better mental health and wellbeing in childhood are seen outside the health sector: e.g. for criminal justice and education.
  • Investing in psychological interventions for post natal depression amounts to an imputed net benefit of approximately £300 million for England. The calculation is conservative, as it doesn’t take into account the impacts beyond one year for mothers or the impacts on the mental and physical health of their spouses and children.
  • Promotion of mental health in the workplace delivers a return of investment of up to €9 for very €1 spent.
  • Debt management services may deliver a return on investment of more than €3.5 per €1 spent, by countering the increased risk of developing stress and anxiety related disorders.

Partnering with a provider of early intervention services

Are you looking for a tailored early intervention campaign to fit the needs of your community? Bridge provides support to over 1,000 people every year through a full range of services, from 24-hour supported accommodation to flexible visiting support. Our dedicated staff are available to guide you on current thinking, evidence-based treatment and professional practices that can be implemented in a local setting.