New WHO-led study encourages spending on mental health (The Lancet Psychiatry, 12 April 2016)

A new study published in The Lancet Psychiatry suggests that investing in treatment for depression and anxiety leads to a four-fold return- every US$ 1 invested in scaling up treatment for depression and anxiety leads to a return of US$ 4 in better health and ability to work.

Background Information:

Absenteeism: The act of being absent from work

Presenteeism: Refers to the state of being present at work, but, because of illness or other medical conditions, not fully functioning.

https://hbr.org/2004/10/presenteeism-at-work-but-out-of-it

Key Messages:

The prevalence of Depression and Anxiety is increasing

Between 1990 and 2013, the number of people suffering from depression and/or anxiety increased by nearly 50%, from 416 million to 615 million.

Nearly 10% of the world’s population is affected, and mental disorders account for 30% of the global non-fatal disease burden.

Returns on investment in treatment far outweigh the costs

The new study calculated treatment costs and health outcomes in 36 low-, middle- and high-income countries for the 15 years from 2016-2030. These countries account for 80% of the global population.

The estimated costs of scaling up treatment, primarily psychosocial counselling and antidepressant medication, amounted to US$ 147 billion. Yet the returns far outweigh the costs.

A 5% improvement in labour force participation and productivity is valued at US$ 399 billion, and improved health adds another US$ 310 billion in returns. (The investigators calculated a 5% decrease in absenteeism and a similar reduction in presenteeism. This translates to improved productivity. The investigators report a gain of close to 1 work day per month.)

Cost estimates (2016-2030)

For all 36 countries, the total cost amounts to US$91 billion for depression and $56 billion for anxiety disorders.

Treatment of mild cases accounts for less than 10% of total costs for depression and 20% for anxiety disorders.

After standardising for population size, the cost is actually quite low; for depression treatment, the average annual cost during 15 years of scaled-up investment is

  • $0·08 per person in low-income countries,
  • $0·34 in lower middle-income countries,
  • $1·12 in upper middle-income countries and
  • $3·89 in high-income countries. 

Per person costs for anxiety disorders are nearly half that of depression.

Challenges:

To reduce the stigma associated with mental illnesses

To increase public spending on mental health

Useful Links:

Link to the WHO news release regarding the article:

http://who.int/mediacentre/news/releases/2016/depression-anxiety-treatment/en/

Link to WHO page with links to fact sheets related to mental health (several updated on 12 April, 2016):

http://who.int/topics/mental_health/factsheets/en/

Link to article in The Lancet Psychiatry (Open Access) [PDF]:

http://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(16)30024-4.pdf

Link to related Comment in The Lancet Psychiatry (Open Access) [PDF]:

http://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(16)30031-1.pdf

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