HALIFAX – New research from a Halifax psychiatrist suggests early intervention could relieve some financial burden from the Nova Scotia healthcare system.
Dr. Allan Abbass, who is cross appointed in psychiatry and psychology at Dalhousie University, is the lead author of Long-term healthcare cost reduction with Intensive Short-term Dynamic Psychotherapy in a tertiary psychiatric service, which was published in the Journal of Psychiatric Research.
The study looked at 890 patients in Nova Scotia who had emotional issues stemming from childhood trauma that manifested itself into physical symptoms.
“They may have chest pain, abdominal pain, headache, shortness of breath, weakness, dizziness. These are some of the common symptoms that lead to emergency visits,” Abbass said.
“People end up using the system a lot. Medications are prescribed. Tests are done. Referrals are made. If the cause is more of an emotional factor that’s triggering symptoms, it’s not going to be found through those [methods]. It’s a huge economic burden.”
The patients were followed over nine years and were offered psychotherapy. This intervention involves one-on-one therapy with the patient to discuss what he or she is experiencing.
“We form a therapeutic bond with the patient. What happens is the feelings start showing up very quickly. When that happens, we can see what way they physically manifest,” Abbass said.
“We can then diagnose if there is an emotional factor. We can help the person then to resolve that by starting to identify the feelings and starting to feel the feelings.”
In addition to better treating the patient, Abbass said his study found that psychotherapy had significant financial benefits to the province’s healthcare system.
The research shows a 31.1 per cent reduction in physician costs and 71.1 per cent reduction in hospital costs over a three year period.
With early intervention, the cost per patient plummeted $12,628 over three years of follow-up, which contrasts greatly with psychotherapy treatment costs of $708.
Abbass said the findings could have a huge impact on the landscape of healthcare in Nova Scotia.
“How and where we spend our health dollars and whether inventions like this may be able to reduce the financial burden and increase services available to people, this may mean possible reduction in wait times for services, reduction of wait lists for counseling services,” he said.
The service is not yet provided province-wide, something Abbass hopes to change, especially considering the model is already used in other countries.
“It’s been picked up in other places as an effective, cost-saving measure so we’re hoping for the same success locally,” he said.
“Relatively we are behind the rest of the world in using a Nova Scotia product that’s being taught around the world, which is ironic in a way.”
Support from the government, healthcare professionals
Abbass met with Nova Scotia Health Minister Leo Glavine Tuesday to discuss his findings. Glavine told Global News the research is good for the province’s bottom line.
“By taking a number of patients in different settings – in the emergency room, with general practitioners, with internal medicines – we’re able to see dramatic cost reduction and repeat visits in those settings. This is why it’s of great interest to the department,” Glavine said.
Anna Webster, a psychologist (candidate register) with Lesley Hartman & Associates, said the results of Abbass’s research are not surprising.
“It’s kind of like a front line intervention for mental health issues, which we know from research can be just as effective as medicine,” she said.
Webster said that early intervention is important to stem the issue at the root, before patients show bigger problems and before they turn to healthcare services.
“I think it’s an investment we can’t afford to pass up. If you look at it, it would have huge cost-saving benefits for the province as well as it benefits the well-being, physical and emotional, of Nova Scotians.”
Pamela Rubin, a counselor at Living Well Integrative Health Centre, said the research shows prevention is key to reducing emergency room visits and hospitalization.
“To see this start to be talked about in concrete, monetized terms is very useful,” she said.
“We’re really talking about a paradigm shift where we see people’s health as a totality. The mind and the body aren’t separate. We have to start seeing people holistically.”