Cost effectiveness of a community-based crisis intervention program for people bereaved by suicide.
BACKGROUND
Postvention services aim to ameliorate distress and reduce future incidences of suicide. The StandBy Response Service is one such service operating in Australia for those bereaved through suicide. Few previous studies have reported estimates or evaluations of the economic impact and outcomes associated with the implementation of bereavement/grief interventions.


OBJECTIVE
To estimate the cost-effectiveness of a postvention service from a societal perspective.


METHODS
A Markov model was constructed to estimate the health outcomes, quality-adjusted life years, and associated costs such as medical costs and time off work. Data were obtained from a prospective cross-sectional study comparing previous clients of the StandBy service with a control group of people bereaved by suicide who had not had contact with StandBy. Costs and outcomes were measured at 1 year after suicide bereavement and an incremental cost-effectiveness ratio was calculated.


RESULTS
The base case found that the StandBy service dominated usual care with a cost saving from providing the StandBy service of AUS $803 and an increase in quality-adjusted life years of 0.02. Probabilistic sensitivity analysis indicates there is an 81% chance the service would be cost-effective given a range of possible scenarios.


CONCLUSIONS
Postvention services are a cost-effective strategy and may even be cost-saving if all costs to society from suicide are taken into account.
<location>Griffith Health Institute, Griffith University, Brisbane, QLD, Australia</location>
Tracy
T
Comans
Victoria
V
Visser
Paul
P
Scuffham
D000328:Adult; D001315:Australia; D001601:Bereavement; D016022:Case-Control Studies; D003156:Community Mental Health Services / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D003419:Crisis Intervention / Q000191:economics / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D015277:Hotlines / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D013315:Stress, Psychological / Q000191:economics / Q000628:therapy*; D013405:Suicide / Q000191:economics / Q000523:psychology; D016896:Treatment Outcome; D000092864:Suicide Prevention
cost effectiveness; postvention; suicide