Recorded presentation

Brian T. Yates, PhD¹, Danyelle Mannix¹, Michael C. Freed, MA¹, Jean Campbell, PhD², Matthew Johnsen, PhD³, Jeffrey Merrill, MA⁴, Kristine Jones, PhD⁵, Crystal R. Blyler, PhD⁶, and Bonnie J. Schell, MA⁷. (1) Dept. of Psychology, American University, 4400 Mass. Ave., N.W., American University, Washington, DC 20016-8062, 301-775-1892, byates@american.edu, (2) Missouri Institute of Mental Health, University of Missouri--Columbia, 5400 Arsenal Street, Saint Louis, MO 63139, (3) Center for Mental Health Services Research, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, (4) Department of Psychiatry, Robert Wood Johnson Medical School, 671 Hoes Lane, University Behavioral HealthCare at Piscataway, Piscataway, NJ 08854-5627, (5) Center for the Study of Issues in Public Mental Health, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, (6) SAMHSA Center for Mental Health Services, 1 Choke Cherry Lane, Room 6-1009, Rockville, MD 20857, (7) Mental Health Client Action Network, 1051 Cayuga Street, Santa Cruz, CA 95062

This presentation describes and analyzes potential determinants of the costs, benefits, cost-effectiveness, and cost-benefit of 8 programs helping 1,827 consumers and representing 3 models for offering Consumer Operated Services (COS) in addition to traditional mental health services (TMHS). We report: a) total program cost, b) cost per consumer visit, c) cost per consumer per quarter, d) monetary benefits (health care cost-savings, employment income), e) cost-effectiveness, and f) cost-benefit for each program and for the 3 types of programs. Cost variables a) through c) are reported for 1) budgeted or expended monies, 2) volunteered time and donated resources, and 3) the sum of monetary plus volunteered time and donated resources. A ratio was calculated to quantify the ability of the program to mobilize community resources to buttress COS budgets. Effectiveness measures included enhanced well-being. Benefits were measured as reductions in consumers’ utilization of health services such as emergency room visits and hospitalization, plus increased consumer income. Cost-effectiveness was measured for each consumer, each program, and each type of program as the ratio of the cost of COS for a consumer against increments experienced by that consumer in quality of life and well-being (the major outcome variables for the study, as determined by additional research). Cost-benefit was measured as both the ratio of benefits over costs, and net benefit (benefits minus costs). COS were found to vary substantially in cost. Delivery system, rather than program model, determine most COS costs. Benefits, cost-effectiveness, and cost-benefit of TMHS versus TMHS+COS were compared statistically.

Learning Objectives: After this presentation, the participant will be able to

• Explain the differences between costs and benefits.
• Determine whether a study is reporting just costs, or cost-effectiveness or cost-benefit findings.
• Explain the difference between cost-effectiveness and cost-benefit.
• Offer explanations of how costs may be determined more by delivery system than by program model.
• Explain limitations of studies that report only effectiveness, only cost, only cost-benefit, or only cost-effectiveness.

Keywords: Cost Issues, Consumer Direction

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation