Wednesday, April 13, 2016

Investing in Global Mental Health Could Save Billions, Report Suggests

Scaling up treatment for people living with depression and anxiety disorders around the world can lead to billions of dollars in savings, according to a study published yesterday by the World Health Organization (WHO).

Depression and anxiety not only contribute to lost health, but lost economic output. In 2010, an estimated $2.5 to $8.5 trillion in lost output was attributed to mental, neurological, and substance use disorders worldwide. While previous international economic studies of mental health have examined the economic effect of these disorders, the cost-effectiveness of different intervention strategies, and the cost of scaling up care, these studies had not evaluated the value of both economic and health benefits of intervention scale up.

To estimate the global return on an investment in a scaled-up response to depression and anxiety disorders worldwide, Dan Chisholm, Ph.D., and colleagues calculated treatment costs and health outcomes in 36 countries between 2016 and 2030, assuming a linear increase in depression and anxiety treatment coverage. The analysis showed that the estimated cost for a modest increase in mental health care for depression and anxiety would amount to $147 billion ($91 billion for depression and $56 billion for anxiety disorders), a value of $399 billion in economic benefits and health returns.

“Notwithstanding the general limitations of any projection modelling study, the analysis suggests that the investment needed to substantially scale up effective treatment coverage for depression and anxiety disorders in the 36 countries included in this analysis is substantial… Extending the scope to the 20% of the world’s population not living in the 36 countries represented in the study would increase the cost by about 25% to $184 billion,” the authors wrote. “However, the returns to this investment are also substantial, with benefit to cost ratios of 2.3 to 3.0 when economic benefits only are considered, and 3.3 to 5.7 when the value of health returns is also included.”

“The Chisholm study brings rigor to the economic case, but there are many other important reasons to consider enhanced investment in global mental health, not least of which are justice, equity, human rights, and the reduction of suffering,” past APA President Paul Summergrad, M.D., chair of the Department of Psychiatry at Tufts University School of Medicine, wrote in a related commentary.

Summergrad outlined several actions to help advance the global mental health infrastructure before concluding, “…to achieve a sustained effect on global mental health, major international organizations, governments, and foundations will need to be engaged. The publication of this report is therefore timely, coinciding with the first-ever joint meeting of the World Bank and WHO on the global economic effect of depression and anxiety on April 13 to 14, 2016. This is a very important initial step, but only a predicate to overdue and much needed bold action.”
Image courtesy of World Health Organization


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