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Positive behavioural support has been considered as a valuable alternative to residential care for children and adolescents with learning disabilities and behaviour that challenges. While recent evidence suggests it has a positive impact on behaviour and carer ability to cope, there is little evidence of its economic costs or benefits. The paper aims to discuss this issue.

An exploratory cross-sectional study was conducted to evaluate the cost of providing positive behavioural support to ten children and adolescents with learning disabilities and behaviour that challenges living in the community in Ealing, West London. Comparison was also made with the cost estimate of possible alternative support packages for children and adolescents with learning disabilities and behaviour that challenges in the UK, as obtained through a Delphi exercise.

Total cost of services per child was £1,454 per week for young people supported short-term, and £1,402 supported long-term. Children and adolescents were making use of a range of social care, education and health services. Over the full sample, half of the total cost was accounted for by education services. The Delphi exercise estimated the weekly cost of residential-based care as more expensive than the cost of community-based care for children and adolescents with learning disabilities and behaviour that challenges. At the end of the ITSBS, all ten children and adolescents initially at risk of imminent residential placement were living in the community with less service-intensive and less expensive support. This suggests that avoiding residential-based care could reduce costs in the long term.

Positive behavioural support has potential to support people with learning disabilities and behaviour that challenges in the community, leading to potential cost advantages. However, this is a small study and more robust research is needed.

The purpose of this paper is to establish the effectiveness of self-management training as an intervention for people using secondary mental health services.

A self-management and peer support intervention was developed and delivered by secondary mental health service users to 262 people with psychiatric diagnoses living in the community. Data on wellbeing and health-promoting behaviour were collected at three time points (baseline, six, and 12 months).

Participants reported significant improvements in wellbeing and health-promoting lifestyle six and 12 months after self-management training. Peer-led self-management shows potential to improve long-term health outcomes for people with psychiatric diagnoses.

Due to the lack of a control group, the positive changes cannot definitively be attributed to the intervention. Other limitations were reliance on self-report measures, and the varying numbers of completers at three time points. These issues will be addressed in future studies.

The evaluation demonstrated the effectiveness of self-management training for people with psychiatric diagnoses, suggesting self-management training may bring significant wellbeing gains for this group.

This study represents a first step in the implementation of self-management approaches into mental health services. It demonstrates the feasibility of people with psychiatric diagnoses developing and delivering an effective intervention that complements existing services.

This is the first study to investigate the effectiveness of a self-management training programme developed and delivered by mental health service users in the UK.

The purpose of this paper is to evaluate the effectiveness and cost-effectiveness of a peer-led self-management intervention for people with severe mental disorders.

This is a one-arm longitudinal study without control group. In all, 262 adults with (self-reported) severe mental disorders, who have used secondary mental health services and were living in the community were evaluated at three time points (baseline, six and 12 months). Socio-demographic data were collected at baseline. Wellbeing (Warwick-Edinburgh Mental Wellbeing Scale), functional living skills (Health Promoting Lifestyle Profile II) and service use (Client Service Receipt Inventory) data were assessed over time.

Self-management for people with severe mental disorders improved wellbeing and health-promoting lifestyles. After an increase in the short term, costs appeared to decrease in the longer term, although this change was not statistically significant. Due to the lack of a control group, the authors are unable to attribute those changes to the intervention only. Nevertheless, the self-management intervention appears to warrant further attention on both wellbeing and economic grounds.

Self-management may facilitate recovery, helping to support people with severe mental disorders at no additional cost. Given recent emphasis on recovery, peer workers and self-management, this peer-led self-management approach for people with severe mental disorders appears to have potential.

The purpose of this paper is to provide a commentary on the challenges associated with evaluating the costs and cost-effectiveness of interventions for people with learning disabilities and behaviour that challenges.

The paper is a commentary on a range of evidence relating to the findings of “Positive behavioural support for children and adolescents with learning disabilities: an initial exploration of service and costs”. Specific attention is paid to gaps in the literature and the evidence base for the cost of care for people with learning disabilities and behaviour that challenges.

Recommendations for person-centred support and increased use of behavioural and psychological interventions for people with learning disabilities and behaviour that challenges are based on limited evidence. The literature is particularly sparse in relation to the cost implications for service providers or informal carers of implementing such interventions and the question of whether they reduce costs through preventing residential placements and long-term inpatient admissions.

More high-quality research is required in the area of behavioural and psychological interventions for people with learning disabilities and behaviour that challenges. Trials in this area should include high-quality economic evaluations including budget impact analysis to provide information on the cost implications for different government agencies and cost-effectiveness analysis incorporating impact on quality of life.