The “Personal Health Budget” intervention model in early psychosis: preliminary findings from the Parma experience

Lorenzo Pelizza 1, Emanuela Leuci 1, Giulia Landi 1, Emanuela Quattrone 1, Silvia Azzali 2, Annalisa Pelosi 3, Patrizia Ceroni 1, Caterina Soncini 1, Maria Cristina Daolio 1, Raffaella Dall’Aglio 2, Giuseppina Paulillo 1, Clara Pellegrini 3, Andrea Raballo 4,5, Pietro Pellegrini 1

1 Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Italy; 2 Department of Mental Health and Pathological Addiction, Azienda USL-IRCSS di Reggio Emilia, Italy; 3 Department of Medicine and Surgery, Università degli Studi di Parma, Italy; 4 Department of Medicine, Division of Psychiatry, Clinical Psychology and Rehabilitation, Università degli Studi di Perugia, Italy; 5 Center for Translational, Phenomenological and Developmental Psychopathology, Perugia University Hospital, Università degli Studi di Perugia, Italy

Objectives

Personal Health Budget (PHB) has recently been provided to people with severe mental illness, reflecting a policy shift towards a personalized mental health care based on individual unmet needs. However, evidence on effectiveness of PHB initiatives is still limited. Aim of this research was to provide preliminary data about the beneficial effects of adding PHB to a multicomponent EIP intervention in patients with First-Episode Psychosis (FEP) along a 2-year follow-up period. 

Methods

Participants (n = 49) were FEP patients, aged 18-50 years, entered the “Parma Early Psychosis” program and completing the Health of Nation Outcome Scale (HoNOS), the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF). Friedman test for repeated measure (with Wilcoxon test as post-hoc procedure) was performed to evaluate the longitudinal stability of functioning and clinical parameters. A linear regression analysis was also carried out. 

Results

A significant effect of time on all HoNOS, BPRS and GAF scores along the 2 years of follow-up was found. Regression analysis results specifically showed a relevant association between a PHB multiaxial intervention and the longitudinal decrease in BPRS “Negative Symptoms” subscores, as well as in HoNOS “Behavioral Problems” and “Social Problems” scores. 

Conclusions

Our results support the general applicability of a PHB approach within an “Early Intervention in Psychosis” program for help-seeking adults with FEP.

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