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Is it worth investing in mental health promotion and prevention of mental illness?: a systematic review of the evidence from economic evaluations

By Ingrid Zechmeister, Reinhold Kilian and David McDaid

Abstract

Background While evidence on the cost of mental illness is growing, little is known about the cost-effectiveness of programmes in the areas of mental health promotion (MHP) and mental disorder prevention (MDP). The paper aims at identifying and assessing economic evaluations in both these areas to support evidence based prioritisation of resource allocation. Methods A systematic review of health and non health related bibliographic databases, complemented by a hand search of key journals and analysis of grey literature has been carried out. Study characteristics and results were qualitatively summarised. Economic evaluations of programmes that address mental health outcome parameters directly, those that address relevant risk factors of mental illness, as well as suicide prevention interventions were included, while evaluations of drug therapies were excluded. Results 14 studies fulfilled the inclusion criteria. They varied in terms of topic addressed, intervention used and study quality. Robust evidence on cost-effectiveness is still limited to a very small number of interventions with restricted scope for generalisability and transferability. The most favourable results are related to early childhood development programmes. Conclusion Prioritisation between MHP and MDP interventions requires more country and population-specific economic evaluations. There is also scope to retrospectively add economic analyses to existing effectiveness studies. The nature of promotion and prevention suggests that innovative approaches to economic evaluation that augment this with information on the challenges of implementation and uptake of interventions need further development

Topics: RA Public aspects of medicine
Publisher: BioMed Central
Year: 2008
DOI identifier: 10.1186/1471-2458-8-20
OAI identifier: oai:eprints.lse.ac.uk:5713
Provided by: LSE Research Online

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Citations

  1. (2007). A B: Target groups for the prevention of late-life anxiety. doi
  2. (2005). A Review and Analysis of the Clinical and CostEffectiveness Studies of Comprehensive Health Promotion and Disease Management Programs at the Worksite: Update VI 2000–2004. doi
  3. (2004). A: Benefits and Costs of Prevention and Early Intervention Programs for Youth. Washington , Washington State Institute for Public Policy;
  4. (2006). A: Cost-effectiveness of preventing depression in primary care patients.
  5. (1997). al.: Long-term effects of home visitation on maternal life course and child abuse and neglect. Fifteen-year follow-up of a randomized trial. JAMA doi
  6. (1997). AM: Primary prevention mental health programs: The future is exciting.
  7. (2003). Antes G: Five steps to conducting a systematic review. doi
  8. (2007). Australian school-based prevention and early intervention programs for anxiety and depression: a systematic review.
  9. (2000). B: An educational intervention for front-line health professionals in the assessment and management of suicidal patients (The STORM Project). Psychological Medicine doi
  10. (2001). Buttar A: The Cost-Utility of Screening for Depression in Primary Care. Annals of Internal Medicine doi
  11. (2006). CJL: Global burden of disease and risk factors. New York/Washington , The World Bank/Oxford
  12. (2005). Commission of the European Communities: Improving the mental health of the population: Towards a strategy on mental health for the European Union. Green Paper. Brussels , Health and Consumer Protection Directorate, European Commission;
  13. (1992). Cost-benefit analysis of an educational program for general practitioners by the Swedish Commitee for the Prevention and Treatment of Depression. Acta Psychiatrica Scandinavica doi
  14. (2005). Cost-effectiveness of an Intervention to Prevent Depression in At-Risk-Teens. Archives of General Psychiatry doi
  15. (2006). Early interventions for psychosis. Cochrane Database Systematic Reviews doi
  16. (2005). Economic Evaluation and Public Health: Mapping the Literature. London , LSE;
  17. (2004). Exceptional Returns. Economic, Fiscal and Social Benefits of Investment in Early Childhood Development. Washington , Economic Policy Institute;
  18. (2001). Financial cost of social exclusion: follow up study of antisocial children into adulthood. doi
  19. (2005). Fombonne E: The Maudsley long-term follow-up of child and adolescent depression. Predicting costs in adulthood. European Child and Adolescent Psychiatry doi
  20. (2000). for the QUOROM Group: Improving the quality of reports of metaanalyses of randomised controlled trials: the QUROM statement. doi
  21. (2005). GL: Methods for the Economic Evaluation of Health Care Programmes. 3rd edition.
  22. (2005). Hendin H: Suicide prevention strategies. A systematic review. doi
  23. (1989). High-risk children in young adulthood: A longitudinal study from birth to 32 years. doi
  24. (2000). Liimatainen MR: Mental health in the workplace. Geneva , International Labour Organisation;
  25. (2006). LL: Cost-effectiveness of a preventive counseling and support package for postnatal depression. doi
  26. Longitudinal Studies:
  27. (2002). Making the most of it. Economic evaluation in the social welfare field. York , Joseph Rowntree Foundation; doi
  28. (2003). Maternal depression, parent-child relationships, and resilient outcomes in adolescence. doi
  29. (2005). Mental health promotion and mental disorder prevention. A policy for Europe. doi
  30. (1997). Meta-Analysis of Interventions to Prevent Mental Health Problems among Youth: A Public Health Commentary.
  31. (2005). Organization: Mental Health Action Plan for Europe. Facing the Challenges, Building Solutions. Copenhagen , World Health Organization;
  32. (2001). Organization: Mental health: New understanding new hope. doi
  33. (2002). Organization: Prevention and promotion in mental health. doi
  34. Organization: Prevention of mental disorders. Effective Interventions and Policy Options.
  35. (2004). Penelope H: A census of economic evaluations in health promotion. Health Education Research doi
  36. (2005). Preventing the Incidence of New Cases of Mental Disorders: A Meta-Analytic Review. doi
  37. (2005). Prevention in psychiatry. Die Psychiatrie
  38. (1998). Primary prevention mental health programs for children and adolescents are effective. doi
  39. (2004). Psychological and/ or educational interventions for the prevention of depression in children and adolescents. Cochrane Database Systematic Reviews doi
  40. (2003). Reducing injuries among Native Americans: five cost-outcome analyses. Accident Analysis & Prevention doi
  41. (2002). Royal College of Psychiatrists: Prevention in Psychiatry. Report of the Public Policy Committee Working Party.
  42. (2006). Screening and early psychological interventions for depression in schools: systematic review and meta-analysis. European Child and Adolescent Psychiatry doi
  43. (2002). Searching literature databases for health care economic evaluations: how systematic can we afford to be? Medical Care doi
  44. (2004). Securing good health for the whole population.
  45. (2007). Shoud we invest in suicide prevention programs?
  46. (2005). Show me the child at seven: the consequences of conduct problems in childhood for psychosocial functioning in adulthood. doi
  47. (2005). The High/Scope. Perry Preschool study through age 40. Summary, conclusions and frequently asked questions. Ypsilanti , High/Scope Research Foundation; doi
  48. (2007). The Mheen Group: Implementing mental health economic evaluation evidence: Building a bridge between theory and practice . doi
  49. (2004). The outcomes and costs of Home-Start support for young families under stress. doi
  50. (2001). The prevention of mental disorders in school-aged children: Current state of the field. Prevention & Treatment doi
  51. (2002). The prevention of mental disorders in young people.
  52. (2004). The Social Support and Family Health Study: a randomised controlled trial and economic evaluation of two alternative forms of postnatal support for mothers living in disadvantaged inner-city areas. Health Technology Assessment
  53. (1996). TO: Guidelines for authors and peer reviewers of economic submissions to the BMJ. doi
  54. (2001). TR: Prevention of childhood depression: recent findings and future prospects. Biological Psychiatry doi
  55. (1999). Übertragung der Ergebnisse ökonomischer Evaluationsstudien aus dem Ausland auf Deutschland: Probleme und Lösungsansätze.
  56. (2001). Undertaking Systematic Reviews of Research on Effectiveness – CRD's Guidelines for those Carrying out or Commissioning Reviews. York , NHS Centre for Reviews and Disseminations;
  57. (2004). Waters E: The challenges of systematically reviewing public health interventions. doi
  58. Woodhouse A: Evaluation of the first phase of Choose life: the national strategy and action plan to prevent suicide in Scotland. Edinburgh , Scottish Executive Social Research; doi
  59. (2007). Woodhouse A: Issues in the economic evaluation of suicide prevention strategies: practical and methodological challenges. Discussion Paper 2407. London , PSSRU;
  60. (2003). World Psychiatric Association: Consensus Statement on Psychiatric Prevention. Newsletter doi

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