Cost implications of treatment non-completion in a forensic personality disorder service

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Citation: Christopher James Sampson, Marilyn James, Nick Huband, Steve Geelan, Mary McMurran (2013) Cost implications of treatment non-completion in a forensic personality disorder service. Criminal Behaviour and Mental Health (RSS)
DOI (original publisher): 10.1002/cbm.1866
Semantic Scholar (metadata): 10.1002/cbm.1866
Sci-Hub (fulltext): 10.1002/cbm.1866
Internet Archive Scholar (search for fulltext): Cost implications of treatment non-completion in a forensic personality disorder service
Download: http://onlinelibrary.wiley.com/doi/10.1002/cbm.1866/full
Tagged: Health (RSS) personality disorder (RSS), markov model (RSS), non-completion (RSS), costs (RSS)

Summary

A lot of people with personality disorder do not complete treatment after being admitted to a specialist secure hospital. Evidence shows that non-completion is often associated with poorer treatment outcomes, hospital readmission and higher rates of criminal activity. This study looks at the economic consequences of non-completion of treatment, in terms of the costs incurred by the National Health Service (NHS) and criminal justice system (CJS). It compares total costs over a period of 10 years after admission for people who do complete treatment and people who don't. Case study data are used for a group of people admitted to a medium security hospital personality disorder unit in England. A cohort simulation is constructed to model the expected pathways for this group through different types of hospital, prison and community care. In the 10 years after admission, a person who does not complete treatment incurs on average £52,000 more in costs to the NHS and CJS than a person who completes treatment. The study cannot determine if this is because treatment was not completed or for other reasons. Nevertheless, the study highlights that people who do not complete treatment incur far greater costs. It may be possible to address this in part by introducing routine monitoring of treatment completion or by improving the process of selection into treatment.