Cost, effectiveness, and cost-effectiveness of a collaborative mental health care program for people receiving short-term disability benefits for psychiatric disorders.
OBJECTIVE
To examine the cost, effectiveness, and cost-effectiveness of a collaborative mental health care (CMHC) pilot program for people on short-term disability leave for psychiatric disorders.


METHODS
Using a quasi-experimental design, the analyses were conducted using 2 groups of subjects who received short-term disability benefits for psychiatric disorders. One group (n = 75) was treated in a CMHC program during their disability episode. The comparison group (n = 51) received short-term disability benefits related to psychiatric disorders in the prior year but did not receive CMHC during their disability episode. People in both groups met screening criteria for the CMHC program. Differences in cost and days absent from work were tested using Student t tests and confirmed using nonparametric Wilcoxon rank sum tests. Differences in return to work and transition to long-term disability leave were tested using chi-square tests. The cost-effectiveness analysis used the net benefit regression framework.


RESULTS
The results suggest that with CMHC, for every 100 people on short-term disability leave for psychiatric disorders, there could be $50 000 in savings related to disability benefits along with more people returning to work (n = 23), less people transitioning to long-term disability leave (n = 24), and 1600 more workdays.


CONCLUSIONS
CMHC models of disability management based on our Canadian data may be a worthwhile investment in helping people who are receiving short-term disability benefits for psychiatric disorders to receive adequate treatment.
Dewa
Carolyn S
CS
Centre for Addiction and Mental Health, Health Systems Research and Consulting Unit, Toronto, Ontario. carolyn_dewa@camh.net
Hoch
Jeffrey S
JS
Carmen
Glenn
G
Guscott
Richard
R
Gusscott
Richard
R
Anderson
Chris
C
D000328:Adult; D002170:Canada; D019090:Case Management / Q000191:economics; D003155:Community Mental Health Centers / Q000191:economics*; D003299:Cooperative Behavior; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007342:Insurance Benefits / Q000191:economics; D018868:Insurance, Disability / Q000191:economics*; D033183:Interdisciplinary Communication; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000534:rehabilitation*; D008875:Middle Aged; D010348:Patient Care Team / Q000191:economics*; D012017:Referral and Consultation / Q000191:economics; D012050:Rehabilitation, Vocational / Q000191:economics