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Using epidemiological evidence to forecast population need for early treatment programmes in mental health: a generalisable Bayesian prediction methodology applied to and validated for first-episode psychosis in England
- Source :
- The British Journal of Psychiatry
- Publication Year :
- 2021
-
Abstract
- BackgroundMental health policy makers require evidence-based information to optimise effective care provision based on local need, but tools are unavailable.AimsTo develop and validate a population-level prediction model for need for early intervention in psychosis (EIP) care for first-episode psychosis (FEP) in England up to 2025, based on epidemiological evidence and demographic projections.MethodWe used Bayesian Poisson regression to model small-area-level variation in FEP incidence for people aged 16–64 years. We compared six candidate models, validated against observed National Health Service FEP data in 2017. Our best-fitting model predicted annual incidence case-loads for EIP services in England up to 2025, for probable FEP, treatment in EIP services, initial assessment by EIP services and referral to EIP services for ‘suspected psychosis’. Forecasts were stratified by gender, age and ethnicity, at national and Clinical Commissioning Group levels.ResultsA model with age, gender, ethnicity, small-area-level deprivation, social fragmentation and regional cannabis use provided best fit to observed new FEP cases at national and Clinical Commissioning Group levels in 2017 (predicted 8112, 95% CI 7623–8597; observed 8038, difference of 74 [0.92%]). By 2025, the model forecasted 11 067 new treated cases per annum (95% CI 10 383–11 740). For every 10 new treated cases, 21 and 23 people would be assessed by and referred to EIP services for suspected psychosis, respectively.ConclusionsOur evidence-based methodology provides an accurate, validated tool to inform clinical provision of EIP services about future population need for care, based on local variation of major social determinants of psychosis.
- Subjects :
- Adult
Male
Mental Health Services
Paper
medicine.medical_specialty
Referral
Adolescent
Population
Bayesian statistics
Care provision
State Medicine
03 medical and health sciences
symbols.namesake
Young Adult
0302 clinical medicine
Early Medical Intervention
medicine
Humans
030212 general & internal medicine
Social determinants of health
Poisson regression
Psychiatry
education
Referral and Consultation
education.field_of_study
Psychotic disorders
business.industry
Health services research
Reproducibility of Results
Bayes Theorem
prediction
Middle Aged
Mental health
health services research
030227 psychiatry
Early intervention in psychosis
Psychiatry and Mental health
England
symbols
Female
epidemiology
business
Needs Assessment
Forecasting
Subjects
Details
- ISSN :
- 14721465 and 00071250
- Volume :
- 219
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- The British journal of psychiatry : the journal of mental science
- Accession number :
- edsair.doi.dedup.....d59233fe7fd6b263b61ec993797ac74c