Population-based service planning for implementation of MBCT: linking epidemiologic data to practice.

Abstract

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. 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). 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. 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.