Research has shown that mental health problems can affect one in three people at some point during their lifetime.
To help commissioners identify the areas of highest risk, this paper discusses how epidemiology studies and prediction tools can help commissioners and service planners allocate resources to support mental health service provision more efficiently.
They review one, freely available, online tool, in particular, called PsyMaptic (Psychiatric Mapping Translated into Innovations for Care), which can be used to predict the need for early intervention psychosis services.
Mental health predictive data
Mental health issues can arise from a variety of situations. While some of the risks are beyond control, genetic background, ethnic background, and familial history, for example, other risks, such as socioeconomic group status, deprivation, unemployment, trauma, or substance abuse, may be avoidable with adequate mental health service provision. Epidemiological studies can help commissioners predict which areas are at greatest risk, so that they can position resources and services in the most appropriate areas. There are limited funds available to support population health, and these tools and studies can ensure that the difficult decisions that commissioners are based on reliable and robust evidence.
Evidence-based integrated healthcare
There is a useful diagram highlighting the “three dimensions required for evidence-based integrated healthcare”:
- Evidence-based healthcare – improves the patient experience through prevention and/or better outcomes
- Empirical epidemiology – rigorous studies will highlight potential risk in the population
- Evidence-based public health – reduces the risk of variation in health service delivery.
Commissioners applying evidence-based integrated healthcare will improve health service delivery because:
- Services will become seamless, improving the experience for the patient, and reducing cost to the health service
- Decisions made about resource-allocation will be stronger and more reliable because they are backed by the research evidence and population data
- Access to health services will be more equitable throughout the country, because planning will be informed by data from the local population.
- Service providers will gain a clearer understanding of the needs of their users, and the gaps in service provision.
Early intervention psychosis
Use of epidemiological tools to predict the incidence of early treatment of psychosis is used as an example for this research, because current predictions of early intervention psychosis service need have not been completely accurate. This has led to either insufficient access to these services, leading to a greater demand on emergency psychiatric services, or on the other end of the scale, over-spending on services which are not needed, where money could be best spent elsewhere.
Translational epidemiological tools
PsyMaptic is the tool that the authors are presenting, and it provides “epidemiology ‘on demand’, centred on population need and underpinned by a robust evidence base for first-episode psychosis.” The authors provide a summary table showing how the tool has been tested for accuracy. Towards the end of this paper, they describe the availability of other prediction tools available to support commissioners working in public and mental health.
This is a new tool, and the authors recognise its limitations, but they do demonstrate that it has the potential to help commissioners to allocate resources more efficiently within the populations that they serve.
Within your organisations, think about how efficiently your early intervention psychosis services operate. Do you over-estimate demand or do staff struggle to manage their caseloads? The authors are keen for commissioners to use this epidemiological tool and feedback where it has performed well or not so well. By managing early intervention psychosis services more effectively, there will be benefits for patients, staff, the organisation, and the NHS as a whole.
Kirkbride, JB. (2015) Epidemiology on demand: population-based approaches to mental health service commissioning. BJPsych Bulletin, January, DOI: 10.1192/pb.bp.114.047746 (PDF)
PsyMaptic (Psychiatric Mapping Translated into Innovations for Care)