Chawla_Journal 6 (1)

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Jan 9, 2024

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B. Health Care and Social Services: Long-Term Care and Mental Health Care What is the comparative cost-effectiveness of implementing a Housing First approach versus a With Assertive Community Treatment (ACT) approach in addressing homelessness among individuals with mental illness, and what factors, such as program fidelity and participant characteristics, may moderate the effectiveness of each intervention? We can employ a straightforward cost-benefit analysis approach to respond to this question using an economic model using equations. We can independently calculate the costs and advantages of adopting the Housing First and ACT strategies, compare them, and then judge which is more cost-effective. We may also simulate how the interplay between stable housing and mental health affects the long-term financial effects of these treatments For a cost-benefit analysis, the fundamental equation is: Net benefits = Benefits - Costs The savings in homelessness and mental health care expenses, as well as the favourable economic results linked to increased housing stability and mental health, may be used to evaluate the advantages of adopting Housing First and ACT treatments. The expenses of carrying out the actions, such as the price of providing housing and mental health care, may be estimated. The net advantages of Housing First, for instance, can be calculated as follows: Net benefits of Housing First = Benefits of Housing First - Costs of Housing First Savings on hospital stays, emergency department visits, and incarcerations are just a few of the expenditures that Housing First may prevent. It can also have favourable economic effects on employment and dependency on public assistance due to greater home stability. We may write this equation as follows: Housing First Advantages = Cost Savings + Successful Economic Results The direct expenses of providing housing and assistance services, such as rental subsidies, case management, and help for basic necessities, can be included in the costs of Housing First. We may write this equation as follows: Costs of Housing First = Direct costs of providing housing + Direct costs of support services Similarly, we can estimate the net benefits of ACT as: Net benefits of ACT = Benefits of ACT - Costs of ACT The advantages of ACT may include lower expenditures for hospital stays, inpatient stays, and incarceration as well as the favourable economic effects of improved mental health outcomes, such as higher employment and a reduction in dependency on public assistance. We may write this equation as follows:

Benefits of ACT = Savings in costs + Positive economic outcome The direct expenses of delivering mental health services, such as case management, treatment, and medication management, may be included in the costs of ACT. We may write this equation as follows: Costs of ACT = Direct costs of providing mental health services We can add variables that represent the interaction between mental health status and housing stability, as well as the impact of the interventions on these variables, to model how the intersection between mental health and housing stability impacts the long-term economic outcomes of these interventions. For instance, we may include variables that reflect the number of people who benefit from Housing First and ACT programmes in terms of improved mental health outcomes and stable housing. We can also calculate how these factors affect the net benefits of the interventions over time. Reference: Latimer, E. A., Rabouin, D., Cao, Z., Ly, A., Powell, G., Aubry, T., ... Goering, P. N. (2020). Cost-Effectiveness of Housing First With Assertive Community Treatment: Results From the Canadian At Home/Chez Soi Trial. Psychiatric Services, 69(3), 254-260. doi: 10.1176/appi.ps.201700319

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