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Family Psychoeducation Toolkit - page 53 / 77





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  • Improves staff morale and commitment to this population

  • Multifamily groups serve general case management and other purposes

  • Enhanced reputation and fewer complaints and conflicts with advocates

  • Improves cost-benefit ratio

  • Builds a network of allies for community mental health, especially with family advocacy groups

What are the costs of not using the FPE?

The excess cost associated with not using FPE may include:

  • the continuation of a high relapse rate;

  • unnecessary hospitalizations;

  • frequent crises that must be managed by outpatient, emergency or crisis

  • program staff;

  • unnecessary deterioration of functioning;

  • higher rates of unemployment for consumers;

  • alienation and sometimes political action by families and family advocacy groups.

By contrast, in a statewide study in New York, during the second year of treatment, found that for every $1 in costs for FPE in multifamily groups, there was a $34 savings in hospital costs. In a typical hospital in Maine, there was an average net savings of $4,300 per patient, per year over two years. The minimum reduction in hospitalizations has been about 50%, with some studies achieving up to 75% reductions over time. Ratios of $1 spent for this service to $10 in saved hospitalization costs can be routinely achieved.

Will FPE work in this mental health system and with many different cultures?

FPE was specifically designed for use in publicly funded community mental health services. For instance, the multifamily group version of FPE was developed in the South Bronx under adverse circumstances in a multicultural context. It has been refined to be cost-effective in routine mental health settings in many types of communities. Similar results have been reported in the Watts section of Los Angeles, Pittsburgh, six different cities in New York State, a wealthy suburban county in New Jersey, throughout the state of Illinois and the entire state of Maine, in Spokane, Washington, and in the borough of Harlem in New York City. Services are being provided successfully in nine cities in Scandinavia, to the Asian immigrant community in Melbourne, Australia, to thousands of families in China and in Hungary. It seems unlikely that there is any particular clinical or population group for whom this approach cannot be provided with the same kinds of results, except where there are large numbers of people who have no family or friends who are able to participate (e.g., some parts of Manhattan).

Does FPE require new resources or can resources be reallocated?

In mental health systems in which some psychosocial or psychotherapy services are provided, family psychoeducation can be provided largely by reallocation of services. If multifamily groups are established, total service effort will actually decrease in absolute terms. In systems in which the only service provided is brief medication visits on an infrequent basis, new service effort will have to be provided. However, a recent cost- effectiveness study shows that the extra effort will be more than recouped in saved intensive treatment costs, leading to no net increase in staff time or effort. Some special arrangements may be needed to provide access to families from some cultural groups. For

Family Psychoeducation Toolkit


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