The Association between Patient Activation and Outcomes among Severely Mentally Ill Patients

Little is known about the association between patient activation, health, service utilization, and cost among mental health (MH) patients. Patients aged 18 to 64 with schizophrenia (Sz, n = 43), bipolar disorder (BD, n = 59), or major depressive disorder (MDD, n = 34) completed the Patient Activation Measure for Mental Health (PAM-MH), the Colorado Symptom Index, demographic, socioeconomic, treatment, and social support questionnaire items. Average PAM-MH score indicated BD patients the most activated (66.6 ± 17.5), Sz (57.4 ± 10.4) less activated, and MDD the least activated (55.4 ± 14.6). The MDD cohort had the highest ($27,616 ± 26,229) and the BD had the lowest total annual healthcare cost ($18,312 ± 25,091). PAM-MH score was inversely correlated with healthcare costs and regression analysis showed a PAM-MH score × gender interaction. The strongest negative relationship between PAM and cost was for males. These analyses support the inverse association between PAM-MH and healthcare service utilization and cost.