Is lifestyle coaching a potential cost-effective intervention to address the backlog for mental health counselling? A Rapid Review

AimThe aim of this rapid review was to investigate whether lifestyle coaching could provide a cost-effective alternative to counselling for the UK National Health Service (NHS) treatment of common mental health conditions such as stress, anxiety and depression. MethodsA rapid review approach was used to determine the evidence of health economics evaluations in the field of mental health services. A literature search of PubMed, CINAHL, Cochrane Library, ASSIA, PsycINFO and MEDLINE produced 2807 articles. We removed 778 duplicates, and 2029 study articles remained. Two reviewers screened titles and abstracts (RG and KP), and 37 papers met the inclusion criteria of this review. Following a full-text screening, a further 27 papers were excluded due to lack of relevance. Study designs which did not include economic evaluations (n=15) or did not include an evaluation treatment of mental health conditions with talking therapies (n=15) did not meet the inclusion criteria. Ten papers were included in the final rapid review. ResultsThe database search yielded study articles which focused on the cost-effectiveness of counselling and other talking therapies such as Cognitive Behavioural Therapy (CBT). No literature was found to determine the cost-effectiveness, or effectiveness of lifestyle coaching. Due to a lack of economic evaluations, this review could not determine the potential cost-effectiveness of lifestyle coaching as a means of addressing the backlog for mental health support such as counselling in the NHS. ConclusionThis review highlights the research gap in assessing the cost-effectiveness of lifestyle coaching for treating common mental health disorders. The proposed next step is to evaluate the effectiveness and cost-effectiveness of lifestyle coaching versus current treatment as usual (counselling) by using a feasibility randomised control trial. Paper typeA rapid review Article summaryO_ST_ABSStrengths and limitations of this studyC_ST_ABSO_LIThis rapid review found a range of different economic evaluations of mental health interventions for common mental health issues. C_LIO_LIAll of the study articles found were moderate to high quality, some of the included study articles met all of the checklist criteria. C_LIO_LIThis rapid review found no evidence from a UK study setting. However, all study articles came from OECD countries that share similar legal structures and policies with comparable populations. C_LIO_LIDespite being mentioned in a number of studies, it is unclear what treatment as usual refers to, and is perhaps not as usual as the studies suggest. C_LI