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APHA Scientific Session and Event Listing

Aileen Rothbard, ScD, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Room 3014, Philadelphia, PA 19104, 215-349-8707, rothbard@mail.med.upenn.edu, Naoru Koizumi, PhD, School of Public Policy, George Mason University, 3401 North Fairfax Drive, Arlington, VA 22201, and Gregory K. Brown, PhD, Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104.

Objectives: Previous research has shown that cognitive behavioral therapy (CBT) is cost effective in reducing depression. A recent study found CBT to be effective in reducing sucide for individuals admitted to the ER after an attempted suicide. This study examines the cost-effectiveness of a suicide prevention program using CBT.

Method: A sample of 120 suicide attempters were randomly assigned to a 10 session suicide prevention program using CBT versus enriched care. A cost effective analysis was done 18 months after admission to the program. A Quality Adjusted Life Year (QALY) was constructed as a global outcome measure. Depression free days were converted into QALYs using utility weights assigned to depression based on prior research studies.

Results: The subjects in the analysis were 33 years old, 57% female, 63% African American and 66% unemployed or disabled with over 50% having major depressive disorder with co-occurring substance use. Over the course of two years, 23% of the experimental group had a repeat suicide attempt versus 43% of the controls. The result of the CE analysis showed the incremental cost effectiveness was $ 14,126 per quality adjusted life year at the 18 month follow-up assessment.

Conclusions: Attempted suicide constitutes one of the strongest risk factors for completed suicide in adults. This study suggests that a brief CBT intervention can be cost effective for suicide attempters. The cost of a QALY is within the acceptable range of economic costs (up to $50,000) c0pmpared to other psychological and health interventions.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe components of a brief cognitive behavioral therapy intervention for suicide prevention.
• Develop cost estimates of the intervention compared to treatment as usual.
• construct a quality adjusted life year measure (QALY) and compare it to other interventions in health and behavioral health.

Keywords: Cost Issues, Public Mental Health

Presenting author's disclosure statement:

Any relevant financial relationships? No