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Decrease in health service use and cost following group treatment of patients with personality disorders

School of Psychology, Curtin University of Technology, Perth, Australia, email: S.Egan{at}exchange.curtin.edu.au

Paula R. Nathan, Director

Centre for Clinical Interventions, Perth, Australia

It is well known that patients with personality disorders are one of the groups with the highest use of mental health services and hence one of the most expensive to treat. In an out-patient group treatment centre for personality disorders at Royal Perth Hospital, Australia, we examined service use before and after treatment. This was a retrospective analysis of 153 patients (60% female, mean age 34 years). Treatment was for 6 months and patients attended two eclectic oriented psychotherapy groups each day for 5 days per week. Inclusion criteria were presence of one or more personality disorders. Exclusion criteria were psychosis and antisocial personality disorder.

Hospital database records were examined for the 12 months before and after treatment, and data for psychiatry inpatient bed-days, out-patient visits and presentations at the emergency department were retrieved. Costs included all aspects of service delivery; for example, staff wages and building costs.

Cost was reduced from Aus$1.3 million (Aus$8561 per patient) in the year before treatment to Aus$556 789 (Aus$3639 per patient) in the year after treatment. This was an offset of Aus$753 073 (Aus$4922 per patient). These changes were significant; for example, a 65% reduction in in-patient and bed-days, from 19 days in the year before treatment to 7 in the year after (t(152)=2.52, P=0.01).

Our results are similar to those of others (Dolan et al, 1996; Chiesa & Fonagy, 2002), and suggest that mental health services should fund group psychotherapy for personality disorders as this treatment may result in cost-offsets.

References

CHIESA, M. & FONAGY, P. (2002) From the therapeutic community to the community: a preliminary evaluation of a psychosocial outpatient service for severe personality disorders. Therapeutic Communities, 23, 247 –258.

DOLAN B. M., WARREN, F. M., MENZIES, D., et al (1996) Cost-offset following specialist treatment of severe personality disorders. Psychiatric Bulletin, 20, 413 –417.[Abstract/Free Full Text]

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Egan, S. J. Articles by Nathan, P. R. Search for Related Content PubMed Articles by Egan, S. J. Articles by Nathan, P. R.