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Economic Model of Psychosis using Actual Treatments and Health outcomes (EM-PATH)

John Grace QC PhD Scholarship 2023 – University of Oxford

Supervisors: Professor Belinda Lennox and Associate Professor Apostolos Tsiachristas

Lay Summary: Psychosis is a severe condition that heavily impacts the mental and physical health of the person experiencing it. There are treatments that improve the health of people with psychosis, including talking therapies and medications, especially when received early on. For people experiencing their first episode of psychosis, these are provided through dedicated multi-disciplinary Early Intervention in Psychosis (EIP) teams. The NHS is aiming to improve the quality of psychosis care in England, as well as increase funding for mental health generally. This research aims to work out how the NHS should prioritise different types of early psychosis treatment for different people to make this funding as effective as possible.


We know that these effective early treatments are not received by everyone who could benefit from them. Some people do not (or cannot) engage with treatments they are offered. Treatments will sometimes work better when other circumstances, such as insecure housing, have been resolved, or when the preferences and views of people experiencing psychosis for different treatments are taken on board. Many people with psychosis will receive several treatments at the same time or in sequence, so it is unclear what combination of treatments works best for each individual.


We will use a large dataset on people receiving EIP care in England, alongside interviews with people with psychosis, to understand what treatments are being offered, which treatments they engage with, and how well these work for each individual. We will make an economic model that will show the best way for the NHS to fund psychosis services. This research will help EIP services to improve the treatments they offer and ultimately, provide the best possible care to people with psychosis.


Aim: This project therefore aims to develop a health economic evaluation framework, to support the optimal provision of psychosis care in England in terms of health outcomes, patient experience, equity, and costs and answer the following research questions:


Research Question 1: What combinations and sequences (or packages) of treatment for early psychosis are provided in England in practice, and how do these packages of treatment vary by service user characteristics and circumstances?


Research Question 2: To what extent do service users prefer (by engaging with or expressing satisfaction with) different treatments and packages of treatment, and how do preferences vary by individual characteristics and circumstances?


Research Question 3: What are the effects and costs of packages of psychosis treatment in practice, and how do these vary by service user characteristics, circumstances and preferences?


Research Question 4: For the population of individuals with psychosis in England (and their characteristics, circumstances and preferences), what is the optimal provision of services to care for them?

Research Student: Ed Penington


Hi, my name is Ed and I am starting my PhD at the University of Oxford in October 2023.

I have been working at Oxford’s Health Economics Research Centre (HERC) since 2021 researching health economics and mental health. Since 2022, I have been working on data linkage and health economic analysis for the EXTEND study, which is investigating the impact of duration of EIP care on outcomes for people experiencing psychosis.  Prior to joining HERC, I worked at the Office of the Children’s Commissioner for England, the Institute for Fiscal Studies and Frontier Economics, as well as completing an MSc in Economics at Birkbeck, University of London.


I’m grateful to  Mental Health Research UK for funding this project and look forward to engaging with what it takes to improves services for people with psychosis and contributing what I can.

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