Is it Worth Investing in Mental Health Promotion and Prevention of Mental Illness? A Review of the Evidence from Economic Evaluations
Year: 2007
Type: preprint
Study design: Systematic Review
Abstract: Background: Evidence on the costs of poor mental health has resulted in a growing recognition of the need to promote positive mental health and to prevent the onset of mental illness. However, it has been argued that little is known about the cost-effectiveness and thus how to prioritise between such interventions. Aims of Study: To identify economic evaluations in the areas of mental health promotion (MHP) and prevention of mental illness. The methodological quality of both data on effectiveness as well as costs are analysed and studies are classified according to methodological characteristics and type of intervention. Methods: The study is based on a systematic review of the literature from a range of health and non health related bibliographic databases, complemented by a hand search of key journals and grey literature identified by partners of the 'Mental Health Economics European Network'. The review design goes beyond conventional economic evaluations to identify other relevant economic analysis, most notably economic assessment of the impact of regulatory measures and fiscal changes. Results: Comparatively few high quality studies can be identified, although there is an increasing trend in their production over time. They vary significantly in quality, mostly due to the challenges of assessing effectiveness and measuring outcomes in complex predominantly community based interventions. Evaluations only address a limited range of interventions in MHP and illness prevention; the majority of which are delivered outside the health sector. Discussion: Robust evidence on cost-effectiveness is available, yet only for a very small number of interventions with limited scope for generalisability and transferability to other countries. Thus, evidence-based provision of efficient interventions will be limited. A key question however is the extent to which economic analysis may be retrospectively conducted for interventions with robust evidence of effect. Conclusion If resource allocation is to be supported by cost-effectiveness criteria economic evaluation needs to be extended to the areas of MHP and prevention of mental illness. This may imply a shift of resources from health care to other areas of public policy. Additionally, more thoughts need to be spent on methodological issues and study design. Innovative approaches to evaluation may be required, while the importance of understanding the context in which interventions are delivered will also be critical to issues of generalisability and transferability.
Source: SSRN Electronic Journal
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W3121572800