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Population-Based Service Planning for Implementation of MBCT: Linking Epidemiologic Data to Practice

Dr. Patten is with the Department of Community Health Sciences, University of Calgary, 3330 Hospital Drive N.W., Calgary, Canada, T2N 4N1 (e-mail: patten{at}ucalgary.ca). Dr. Meadows is with the School of Psychology, Psychiatry, and Psychological Medicine, Monash University, Melbourne, Australia. Dr. Meadows is the also the director of Southern Synergy, Southern Health, Victoria, Australia.

OBJECTIVE: The study explored population-based service planning for mindfulness-based cognitive therapy (MBCT). Evidence suggests the usefulness of MBCT in relapse prevention for individuals reporting three or more major depressive episodes. METHODS: Depression data were from the Canadian Community Health Survey. A simulation model estimated recurrence rates and population sizes to sustain MBCT therapists (each conducting two ten-person groups per year). RESULTS: Approximately 4.2% of the population are candidates for MBCT, and about 13 candidates would arise annually per 10,000 population. If MBCT was acceptable to 20%, for example, a population of 200,000 could support two therapists. CONCLUSIONS: A large proportion of the population is eligible for MBCT introduction; however, after introduction, the rate of emergence of candidates would yield a smaller patient pool, which may limit implementation in small population centers. Treatment acceptability is a key variable. These analyses highlight the potential value of epidemiologic data and simulation modeling in planning.

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