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What do we know about economic evaluations of psychosocial interventions to promote mental health and wellness in older people?

By A-La Park, David McDaid, Kristian Wahlbeck and A Forsman


Background/Objectives: A systematic review was undertaken to map what is known about the cost effectiveness of investing in interventions to promote the mental wellbeing of older people and/or to prevent the onset of depression or depressive symptoms in people aged 65 or older. This was undertaken as part of the EU Research Framework Programme funded DATAPREV project, which sought to synthesise high quality research evidence on the effectiveness and cost effectiveness of mental health promoting interventions across the lifespan. Methods: All papers identified in a separate Cochrane review undertaken as part of the DATAPREV project were appraised for economic content. In addition we identified economic evaluations of interventions to promote the mental health and wellbeing of older people in a range of bibliographic databases including Medline, Embase, AgeLine, PsychInfo, ASSIA and Econlit. This was supplemented by a search of the NHS Economic Evaluation Database, a hand search of key journals and scrutiny of key websites. Relevant citations were also searched and retrieved. Papers were independently reviewed and cross-checked by the authors; relevant studies were coded for findings and assessed using a economic evaluation checklist. Results: 114 studies were initially identified, but after scrutiny 22 economic evaluations were included in our final analysis. Economic evaluations were identified in areas including group exercise classes, Tai chi, music and art therapy, self management, lifestyle and health advice, post bereavement support and psychological therapies. Most studies looked at impacts on health, social and long term care systems alone, although a minority also considered impacts in terms of lost opportunities for volunteering and employment, as well as impacts on family carers. While little information was available on the inequality implications of interventions, befriending programmes, exercise classes, and some psychosocial interventions were found to be highly cost-effective for the general older population: having both low costs to the public purse and generating very favourable costs per mental health outcomes or quality adjusted life years gained compared with many interventions currently funded by health care services. Discussion/Conclusions: While modest, an economic case to support investment in mental health promotion interventions for older people is growing. The case for action in the short term, in different countries and contexts, could be strengthened by retrospectively adapting and adding economic analysis to existing effectiveness studies. Such models could be used to assess the economic case for targeting interventions at specific population sub-groups who may otherwise experience poor mental health compared to the population as a whole

Topics: HC Economic History and Conditions, HV Social pathology. Social and public welfare. Criminology, RA Public aspects of medicine
Publisher: Thieme Medical Publishers
Year: 2011
DOI identifier: 10.1055/s-0031-1277835
OAI identifier:
Provided by: LSE Research Online
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