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

BackgroundHealthcare workers experience disproportionately high rates of depression, anxiety, and post-traumatic 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. Mental health support offers are patchy across the UK, and the evidence base around interventions is scarce. The Staff Mental Health Service (SMHS) provides rapid, confidential support for NHS staff across Cambridgeshire and Peterborough. In this study, we report an economic evaluation of this dedicated service. AimsTo assess costs and patient outcomes associated with SMHS treatment, compared with local NHS Talking Therapies (TT) support. MethodA 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 {pound}GBP), clinical outcomes (PHQ-9 and GAD-7 scores), and quality-adjusted life years (QALYs). Additional analyses examined service waiting times and productivity losses. ResultsCosts per patient were slightly higher for SMHS or TT ({pound}614 versus {pound}553), resulting in an incremental cost-effectiveness ratio of {pound}7,126/QALY. Treatment at either SMHS or TT 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 versus 17 days), referral to treatment (22 versus 51 days), and assessment to first treatment (7 versus 30 days; all p<0.001). Productivity losses during waiting periods were lower for SMHS, with an estimated value of {pound}2,018 per patient. ConclusionsThe 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 specialist staff mental health provision within the NHS.