The impact of waiting time on patient outcomes: Evidence from early intervention in psychosis services in E ngland
Open accessAbstract
Recently, new emphasis was put on reducing waiting times in mental health services as there is an ongoing concern that longer waiting time for treatment leads to poorer health outcomes. However, little is known about delays within the mental health service system and its impact on patients. We explore the impact of waiting times on patient outcomes in the context of early intervention in psychosis (EIP) services in England from April 2012 to March 2015. We use the Mental Health Services Data Set and the routine outcome measure the Health of the Nation Outcome Scale. In a generalised linear regression model, we control for baseline outcomes, previous service use, and treatment intensity to account for possible endogeneity in waiting time. We find that longer waiting time is significantly associated with a deterioration in patient outcomes 12 months after acceptance for treatment for patients that are still in EIP care. Effects are strongest for waiting times longer than 3 months, and effect sizes are small to moderate. Patients with shorter treatment periods are not affected. The results suggest that policies should aim to reduce excessively long waits in order to improve outcomes for patients waiting for treatment for psychosis.
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Failure to access the right support at the right time can lead to a worsening of symptoms, comorbidities, and adverse outcomes, including hospitalization or suicide.
“Referral to the appropriate healthcare service is a pivotal point in the treatment pathway, as failure to access the right support at the right time can lead to a worsening of symptoms, comorbidities, and adverse outcomes, including hospitalization or suicide [Williams et al., 2008, Reichert and Jacobs, 2018, De Girolamo et al., 2012].”
From Closing the accessibility gap to mental health treatment with a personalized self-referral chatbot (2024) · cites this paper as Reichert and Jacobs, 2018
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- Authors
- Reichert, A., & Jacobs, R.
- Affiliations
- Centre for Health Economics University of York York UK
- University of York (GB)
- Venue
- Health Economics
- Publisher
- Wiley
- Published
- 2018-07-16
- Volume
- 27
- Issue
- 11
- Pages
- 1772-1787
- ISSN
- 1057-9230 (ISSN-L)
- 1099-1050
- PMC
- PMC6221005
- OpenAlex
- W2884420074
- Cited by
- 189
- References
- 64
- Citations by year
- 2026: 26 · 2025: 38 · 2024: 34 · 2023: 29 · 2022: 33 · 2021: 14 · 2020: 9 · 2019: 5
- FWCI
- 8.23
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Health Economics (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- waiting time, early intervention in psychosis, psychosis, mental health services, treatment delay, patient outcomes, Health of the Nation Outcome Scales, treatment intensity, service utilization, mental health policy
- MeSH terms
- Adult, England, Female, Humans, Male, Mental Health Services, Psychotic Disorders, Socioeconomic Factors, Time Factors, Waiting Lists, Outcome Assessment, Health Care
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