An economic evaluation of a specialist mental health service for healthcare workers in the East of England

Background Healthcare workers experience disproportionately high rates of depression, anxiety, and posttraumatic stress compared with the general population. Within the NHS, work related stress and mental health related sickness absence has increased over the past decade, a trend intensified by COVID-19. The mental health support offers are patchy across the UK, and the evidence base around the interventions is scarce. Staff Mental Health Service (SMHS), provides rapid, confidential support for NHS staff across Cambridgeshire and Peterborough. In this study, we aimed an economic evaluation of this dedicated service. Aims To assess costs and patient outcomes associated with SMHS treatment, compared with local NHS Talking Therapies (TT) support. Method A model based cost consequence analysis comparing two treatment pathways: SMHS or TT, versus TT only. Routinely collected service data and survey responses informed a decision tree model estimating costs (2022/23 GBP), clinical outcomes (PHQ9 and GAD7 scores), and quality adjusted life years (QALYs). Additional analyses examined service waiting times and productivity losses. Results Costs per patient were slightly higher for SMHS or TT (614 GBP vs 553 GBP), resulting in an incremental cost effectiveness ratio of 7,126 GBP/QALY. SMHS option yielded greater improvements in mental health outcomes than TT alone, with mean score reductions of 4.2 versus 2.8 (PHQ-9), and 4.6 versus 2.7 (GAD-7). Median waiting times were substantially shorter at SMHS versus TT from referral to assessment (14 vs 17 days), referral to treatment (22 vs 51 days), and assessment to first treatment (7 vs 30 days; all p<0.001). Productivity losses during waiting periods were lower for SMHS, with an estimated value of 2,018 GBP per patient. Conclusions The SMHS offers a clinically effective and cost-effective model of support for NHS staff, delivering greater improvements in mental health symptoms, substantially shorter waiting times, and reduced productivity losses at only modest additional cost compared with TT. These findings provide early evidence that specialist services for healthcare workers represent good value for money and support continued investment in staff mental health provision within the NHS.

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