Cost and clinical effectiveness of mindfulness-based cognitive therapy for the prevention of depressive relapse in a primary mental health service: a pre–post and follow-up study

Abstract Depression is a highly common condition (World Health Organisation, 2022). Although many people demonstrate recovery there are marked levels of relapse. Mindfulness-based cognitive therapy (MBCT) is effective in preventing relapse. To date, the majority of studies do not primarily focus on the cost-effectiveness of MBCT within health care utilisation and workplace absenteeism. This study aims to explore the effectiveness of MBCT for prevention of depression relapse in patients attending a UK NHS primary care service. An observational (pre–post and follow-up) study of patients ( n =23) who experienced at least three depressive episodes were provided with MBCT. Cost-effectiveness was assessed using self-report measures of service utilisation and employment absence. These were assessed before MBCT, following, and 6 months post. Secondary outcomes assessing clinical effectiveness included measures of depression (PHQ-9), anxiety (GAD-7), and functional impairment (WSAS). There was a significant reduction in absenteeism at work and in health care usage and expenditure at the end of treatment. These improvements were continued during the follow-up period. Secondary outcomes indicated clinical improvements on depression, anxiety and functioning were maintained to follow-up. Key learning aims (1) MBCT is a potentially cost-effective intervention in reducing absenteeism and health care usage for clients with recurrent depression. (2) In line with previous observations, MBCT is a clinically effective intervention for relapse prevention in recurrent depression as recommended by the National Institute for Health and Care Excellence (NICE). (3) Clinicians can consider the use of MBCT for clients with mild depression and recurrent depression within their services as recommended by NICE.