UTILIZATION AND COSTS OF COMMUNITY MENTAL-HEALTH-SERVICES - PRISM PSYCHOSIS STUDY 5

Background The casts and-the effectiveness of mental health services n eed to be evaluated if provision is to be efficient. Service use and c osts are described for two geographical areas in south London. Method Service use was measured comprehensively for clients in both sectors f or two six-month time periods using the Client Service Receipt Intervi ew. This information was combined with unit costs to calculate service costs. The 'hidden' costs of informal care and unsupported accommodat ion were also calculated.Results At baseline significantly more intens ive sector clients had in-patient stays but by the follow-up this diff erence had disappeared. There was significantly more use of supported accommodation in the intensive sector during both time periods. Baseli ne and follow-up total service costs were significantly higher for the intensive sector. Costs were spread disproportionately and a small nu mber of services accounted for a large proportion of cost. Conclusions While the cost at Time 2 was significantly greater in the intensive s ector, this was largely due to the high use of supported accommodation . There was some convergence in cost between the sectors over time.