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Cost-effectiveness of providing university students with a mindfulness-based intervention to reduce psychological distress: economic evaluation of a pragmatic randomised controlled trial
Abstract
Objective: Increasing numbers of young people attending university has raised concerns about the capacity of student mental health services to support them. We conducted a randomised controlled trial (RCT) to explore whether provision of an 8 week mindfulness course adapted for university students (Mindfulness Skills for Students—MSS), compared with university mental health support as usual (SAU), reduced psychological distress during the examination period. Here, we conduct an economic evaluation of MSS+SAU compared with SAU. Design and setting: Economic evaluation conducted alongside a pragmatic, parallel, single-blinded RCT comparing provision of MSS+SAU to SAU. Participants: 616 university students randomised. Primary and secondary outcome measures: The primary economic evaluation assessed the cost per quality-adjusted life year (QALY) gained from the perspective of the university counselling service. Costs relate to staff time required to deliver counselling service offerings. QALYs were derived from the Clinical Outcomes in Routine Evaluation Dimension 6 Dimension (CORE-6D) preference based tool, which uses responses to six items of the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM; primary clinical outcome measure). Primary follow-up duration was 5 and 7 months for the two recruitment cohorts. Results: It was estimated to cost £1584 (2022 prices) to deliver an MSS course to 30 students, £52.82 per student. Both costs (adjusted mean difference: £48, 95% CI £40–£56) and QALYs (adjusted mean difference: 0.014, 95% CI 0.008 to 0.021) were significantly higher in the MSS arm compared with SAU. The incremental cost-effectiveness ratio (ICER) was £3355, with a very high (99.99%) probability of being cost-effective at a willingness-to-pay threshold of £20 000 per QALY. Conclusions: MSS leads to significantly improved outcomes at a moderate additional cost. The ICER of £3355 per QALY suggests that MSS is cost-effective when compared with the UK’s National Institute for Health and Care Excellence thresholds of £20 000 per QALY. Trial registration number: Australian and New Zealand Clinical Trials Registry, ACTRN12615001160527.
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“Peer support may deter students from disclosing personal issues to their peers, while mindfulness programs face operational challenges: universities must invest in staff training, program delivery, and materials, and students must dedicate considerable time and effort to learn and maintain mindfulness practices [10, 11].”
From Canine-assisted therapy in reducing stress and anxiety levels of university students: systematic review and meta-analysis of randomized controlled trials (2025) · cites this paper as [11]
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“Peer support may deter students from disclosing personal issues to their peers, while mindfulness programs face operational challenges: universities must invest in staff training, program delivery, and materials, and students must dedicate considerable time and effort to learn and maintain mindfulness practices [10, 11].”
From Canine-assisted therapy in reducing stress and anxiety levels of university students: systematic review and meta-analysis of randomized controlled trials (2025) · cites this paper as [11]
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Metadata
- Authors
- Wagner, A. P., Galante, J., Dufour, G., Barton, G., Stochl, J., Vainre, M., & Jones, P. B.
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2023-11
- Volume
- 13
- Issue
- 11
- Pages
- e071724
- ISSN
- 2044-6055
- PMC
- PMC10668272
- Cited by
- 7
- References
- 13
- Language
- en
- Funders
- National Institute for Health Research (NIHR) Applied Research Collaboration East of England (N/A)
- University of Cambridge Counselling Service (N/A)
- University of Cambridge Vice-Chancellor’s Endowment Fund (N/A)
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