The Effect of DBT Provision in Reducing the Cost of Adults Displaying the Symptoms of BPD

Abstract

abstract Background: Individuals experiencing Borderline Personality Disorder (BPD) suffer high‐level dysfunction and distress, creating considerable service pressures. Heavy National Health Service (NHS) use often relieves only immediate crises, making BPD one of the most costly psychiatric disorders. Dialectical Behaviour Therapy (DBT) has been shown to be valuable in helping such individuals manage their emotions more effectively, thereby using services available to them more appropriately. Hywel Dda Health Board introduced DBT to improve standards of care for these clients.Aims: To produce the first DBT cost analysis within normal UK treatment provision.Method: Data were collected over three years. Comparisons were made between pre‐ and post‐treatment service use costs with one year of DBT. Unit costs were combined to demonstrate the financial implications. Service establishment costs were included.Results: A £36,000 saving was evident by the end of the post‐treatment year, mainly from lowered in‐patient and community nursing contacts.Conclusions: This study is the first to show that a year's treatment with DBT can reduce secondary mental health care costs associated with BPD relative to pre‐referral cost. Although promising, further research is necessary given the small participant numbers, rural hospital perspective and unknown level of effect from factors such as spontaneous remission.