Papers by Michael Parsonage
The Journal of head trauma rehabilitation
Traumatic Brain Injury (TBI) is a leading cause of death and disability in children and young adu... more Traumatic Brain Injury (TBI) is a leading cause of death and disability in children and young adults and is widely acknowledged to pose major global health and social challenges. This article deals with the accumulating evidence that TBI is associated with criminal behavior. This topical issue contains studies that demonstrate that children who survive TBI are likely to become adults with behavioral problems, that young people with TBI being adjudicated may have poor levels of communicative ability that could place them at a disadvantage in legal proceedings, that the rates of TBI are very high in offender groups, and that TBI is linked to psychiatric disturbance—particularly self-harm. These studies indicate that TBI is an endemic chronic health condition in offender populations and may well be a factor that contributes to the risk of criminal behavior. These studies raise the troubling possibility of a “double hazard” by which children who are socially disadvantaged and who experience a TBI are at increased risk of worse outcomes. Furthermore, poor social-communication skills may increase the chances of externalizing behaviors that eventuate in criminal acts such as aggression against others. In this article, we argue that screening for, and managing, the effects of TBI may improve the well-being of affected young offenders and—potentially—reduce crime.
The Health service journal, Jan 14, 2014
Journal of Affective Disorders, 2016
Anxiety and depression are common among women during pregnancy and the year after birth. The cons... more Anxiety and depression are common among women during pregnancy and the year after birth. The consequences, both for the women themselves and for their children, can be considerable and last for many years. This study focuses on the economic consequences, aiming to estimate the total costs and health-related quality of life losses over the lifetime of mothers and their children. A pathway or decision modelling approach was employed, based on data from previous studies. Systematic and pragmatic literature reviews were conducted to identify evidence of impacts of perinatal anxiety and depression on mothers and their children. The present value of total lifetime costs of perinatal depression (anxiety) was £75,728 (£34,811) per woman with condition. If prevalence estimates were applied the respective cost of perinatal anxiety and depression combined was about £8500 per woman giving birth; for the United Kingdom, the aggregated costs were £6.6 billion. The majority of the costs related to adverse impacts on children and almost a fifth were borne by the public sector. The method was exploratory in nature, based on a diverse range of literature and encountered important data gaps. Findings suggest the need to allocate more resources to support women with perinatal mental illness. More research is required to understand the type of interventions that can reduce long-term negative effects for both mothers and offspring.
Key messages Many people with long-term physical health conditions also have mental health proble... more Key messages Many people with long-term physical health conditions also have mental health problems. These can lead to significantly poorer health outcomes and reduced quality of life. Costs to the health care system are also significant – by interacting with and exacerbating physical illness, co-morbid mental health problems raise total health care costs by at least 45 per cent for each person with a long-term condition and co-morbid mental health problem. This suggests that between 12 per cent and 18 per cent of all NHS expenditure on long-term conditions is linked to poor mental health and wellbeing – between £8 billion and £13 billion in England each year. The more conservative of these figures equates to around £1 in every £8 spent on long-term conditions. People with long-term conditions and co-morbid mental health problems disproportionately live in deprived areas and have access to fewer resources of all kinds. The interaction between co-morbidities and deprivation makes a s...
'Payment by results' is a new way of paying for NHS hospital and community health servi... more 'Payment by results' is a new way of paying for NHS hospital and community health services that will replace the present system of block contracts and locally agreed prices. It is planned to apply in time to all services, including mental health, and to be fully operational in 2008. Under payment by results, hospitals and other providers will be paid according to the quantity of work done, as measured by the numbers and types of cases treated. The amount paid for each type of case, as determined mainly by diagnosis, will be the same everywhere and fixed in advance through a national tariff. The introduction of payment by results will substantially change the pattern of financial incentives and associated risks in the NHS and must therefore be expected to have significant effects on the provision of care. The precise nature and scale of these effects will depend on how the system is designed. There are good reasons for supposing that, across the NHS as a whole, payment b...
Mental health in family medicine, 2010
Medically unexplained symptoms are one of the most commonly encountered symptoms across all healt... more Medically unexplained symptoms are one of the most commonly encountered symptoms across all healthcare settings. They are also responsible for a large proportion of disability in the workforce and decreased quality of life. These patients represent an important clinical phenomenon with considerable direct and indirect economic consequences.This study aims to calculate the economic burden of somatisation among English adults in 2008-2009.Using existing literature, estimates of prevalence, healthcare use and disability were combined in order to calculate the annual cost of healthcare use and productivity loss associated with these patients in excess of non-somatising patients.Based on the results of our analysis, the incremental health care cost incurred by somatising patients is estimated to be £3 billion. This represents approximately 10% of total NHS expenditure on these services for the working-age population in 2008-2009. The cost of sickness absence and decreased quality of life...
Journal of Public Mental Health, 2007
This paper uses economic analysis to develop the case for greater investment in mental health pro... more This paper uses economic analysis to develop the case for greater investment in mental health promotion. One example of a common mental health problem for which there is robust evidence of effective interventions is conduct disorder. The paper estimates that preventing conduct disorders in those children who are most disturbed would save around £150,000 per case (lifetime costs), and that
… Centre for Mental …, 2008
Last year,£ 20.8 million was spent on mental health care in prisons through inreach teams. This i... more Last year,£ 20.8 million was spent on mental health care in prisons through inreach teams. This is 11% of total prison health care spending or just over£ 300 for each member of the prison population. Prison inreach teams aim to provide the specialist mental health ...
Background: Conduct disorders are the most common psychiatric disorders in children and may persi... more Background: Conduct disorders are the most common psychiatric disorders in children and may persist into adulthood in about 50% of cases. The costs to society are high and impact many public sector agencies. Parenting programmes have been shown to positively affect child behaviour, but little is known about their potential long-term cost-effectiveness. We therefore estimate the costs of and longer-term savings from evidence-based parenting programmes for the prevention of persistent conduct disorder.
Methods: A decision-analytic Markov model compares two scenarios: 1) a 5-year old with clinical conduct disorder receives an evidence-based parenting programme; 2) the same 5-year old does not receive the programme. Cost-savings analysis is performed by comparing the probability that conduct disorder persists over time in each scenario, adopting both a public sector and a societal perspective. If the intervention is successful in reducing persistent conduct disorder, cost savings may arise from reduced use of health services, education support, social care, voluntary agencies and from crimes averted.
Results: Results strongly suggest that parenting programmes reduce the chance that conduct disorder persists into adulthood and are cost-saving to the public sector within 5-8 years under base case conditions. Total savings to society over 25 years are estimated at £16,435 per family, which compares with an intervention cost in the range of £952-£2,078 (2008/09 prices).
Conclusions: Effective implementation of evidence-based parenting programmes is likely to yield cost savings to the public sector and society. More research is needed to address evidence gaps regarding the current level of provision, longer-term effectiveness and questions of implementation, engagement and equity.
Contributions to:
J. Beecham et al: School-based social and emotional learning programmes to pre... more Contributions to:
J. Beecham et al: School-based social and emotional learning programmes to prevent condict problems in childhood.
E.M. Bonin & D. McDaid: Bridge safety measures for suicide prevention.
E.M. Bonin et al: Parenting intervention for the prevention of persistent conduct disorders.
D. McDaid et al: Population-level suicide awareness training and intervention.
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Papers by Michael Parsonage
Methods: A decision-analytic Markov model compares two scenarios: 1) a 5-year old with clinical conduct disorder receives an evidence-based parenting programme; 2) the same 5-year old does not receive the programme. Cost-savings analysis is performed by comparing the probability that conduct disorder persists over time in each scenario, adopting both a public sector and a societal perspective. If the intervention is successful in reducing persistent conduct disorder, cost savings may arise from reduced use of health services, education support, social care, voluntary agencies and from crimes averted.
Results: Results strongly suggest that parenting programmes reduce the chance that conduct disorder persists into adulthood and are cost-saving to the public sector within 5-8 years under base case conditions. Total savings to society over 25 years are estimated at £16,435 per family, which compares with an intervention cost in the range of £952-£2,078 (2008/09 prices).
Conclusions: Effective implementation of evidence-based parenting programmes is likely to yield cost savings to the public sector and society. More research is needed to address evidence gaps regarding the current level of provision, longer-term effectiveness and questions of implementation, engagement and equity.
J. Beecham et al: School-based social and emotional learning programmes to prevent condict problems in childhood.
E.M. Bonin & D. McDaid: Bridge safety measures for suicide prevention.
E.M. Bonin et al: Parenting intervention for the prevention of persistent conduct disorders.
D. McDaid et al: Population-level suicide awareness training and intervention.
Methods: A decision-analytic Markov model compares two scenarios: 1) a 5-year old with clinical conduct disorder receives an evidence-based parenting programme; 2) the same 5-year old does not receive the programme. Cost-savings analysis is performed by comparing the probability that conduct disorder persists over time in each scenario, adopting both a public sector and a societal perspective. If the intervention is successful in reducing persistent conduct disorder, cost savings may arise from reduced use of health services, education support, social care, voluntary agencies and from crimes averted.
Results: Results strongly suggest that parenting programmes reduce the chance that conduct disorder persists into adulthood and are cost-saving to the public sector within 5-8 years under base case conditions. Total savings to society over 25 years are estimated at £16,435 per family, which compares with an intervention cost in the range of £952-£2,078 (2008/09 prices).
Conclusions: Effective implementation of evidence-based parenting programmes is likely to yield cost savings to the public sector and society. More research is needed to address evidence gaps regarding the current level of provision, longer-term effectiveness and questions of implementation, engagement and equity.
J. Beecham et al: School-based social and emotional learning programmes to prevent condict problems in childhood.
E.M. Bonin & D. McDaid: Bridge safety measures for suicide prevention.
E.M. Bonin et al: Parenting intervention for the prevention of persistent conduct disorders.
D. McDaid et al: Population-level suicide awareness training and intervention.