Knowledge, attitudes, and practices about severe mental illness and willingness-to-pay for a new integrated care model across 6 European countries: a study protocol

Background People with Severe Mental Illness (SMI) experience a 15–20-year shorter life expectancy than the general population, with increased premature deaths from somatic illnesses, and twice to more than four times the general population’s all-cause mortality risk. Integrated care could potentially improve these outcomes, but implementing it requires financial investment, and we know little about community support for integrated care for people with severe mental illness. This study aims to assess the Knowledge Attitudes and Practices (KAP) of the general population in six European countries towards SMI and integrated care. The study will also assess their preferences and Willingness to Pay (WTP) for a proposed new integrated care model for people with SMI and comorbid physical ailments. Methods The study will comprise an online survey with individuals aged 18+ from 6 countries, representative in terms of age, self-reported gender and education level at minima (1500 individuals by country). A Discrete Choice Experiment valuation method will be used to estimate the value and configuration respondents see in an innovative care model. KAP indicators will be created. Descriptive analyses and comparison between countries will be conducted on these indicators and WTP values. Conclusions This study will provide novel cross-national evidence on public KAP regarding severe mental illness and citizens’ preferences and WTP for integrated mental and physical healthcare. By identifying which components of integrated care are most highly valued, how preferences differ across countries and population groups, and whether knowledge and attitudes are associated with societal support, the findings may inform the implementation of acceptable and sustainable integrated care models. Incorporating this broader societal perspective may help ensure that future models are responsive not only to the needs of people with severe mental illness, but also to the values and expectations of the populations that collectively finance and support healthcare systems.