The global return on investment from preventing and treating adolescent mental disorders and suicide: a modelling study

Abstract

IntroductionDespite the high burden of mental disorders among adolescents and the potentially lifelong consequences of these conditions, access to mental health services remains insufficient for adolescents in low-income and middle-income countries. We conducted an economic modelling study to quantify the potential costs and benefits of mental health interventions to prevent or treat anxiety, depression, bipolar disorder, and suicide among adolescents.MethodsWe developed a Markov model that followed cohorts of adolescents (ages 10–19) from 36 countries to assess the impact of addressing anxiety, depression, bipolar disorder, and suicide during adolescence on health and non-health outcomes through their lives. We estimated the costs of interventions using an ingredients-based approach and modelled impacts on education and employment and the resulting economic, morbidity, and mortality benefits.ResultsImplementing the selected interventions offers a return on investment of 23.6 and a cost of $102.9 per disability adjusted life year (DALY) averted over 80 years. The high return on investment and low cost per DALY averted is observed across regions and country income levels, with the highest return on investment arising from treating mild depression with group-based cognitive behavioural therapy, prevention of suicide attempts among high-risk adolescents, and universal prevention of combined anxiety and depression in low-income and lower-middle income countries.ConclusionsThe high return on investment and low cost per DALY averted suggests the importance and value of addressing mental disorders among adolescents worldwide. Intervening to prevent and treat these mental disorders even only during adolescence can have lifelong health and economic benefits.

Investment case for the prevention and reduction of childhood and adolescent overweight and obesity in Mexico

“…While there have been cost‐effectiveness analyses of various child and adolescent overweight and obesity interventions in low‐ and middle‐income countries (LMIC), 33,34 our review of the literature found that there are no existing investment cases (or cost–benefit analyses) that compare cross‐sectoral interventions for child and adolescent overweight and obesity in LMIC contexts. Investment cases have been demonstrated to provide policymakers with evidence needed to prioritize scarce health resources 35–37 . While a cost‐of‐illness (COI) analysis defines the disease burden's cost to society in economic terms if action is not taken, an investment case builds on the COI analysis by examining the potential economic and health impacts of implementing or scaling health interventions 38 .…”

“…Investment cases have been demonstrated to provide policymakers with evidence needed to prioritize scarce health resources. [35][36][37] While a costof-illness (COI) analysis defines the disease burden's cost to society in economic terms if action is not taken, an investment case builds on the COI analysis by examining the potential economic and health impacts of implementing or scaling health interventions. 38 Hence, this investment case aims to begin to fill that gap by quantifying the health and economic impacts of child and adolescent overweight and obesity in Mexico, an upper-middle income country, and the potential gains from prevention and reduction.…”

Health benefits of physical activity for people with mental disorders: From the perspective of multidimensional subjective wellbeing

“…Existing studies have examined the effectiveness of multiple treatments for mental disorders, such as antidepressants ( 8 ), psychotherapy ( 9 , 10 ), and lifestyle improvement ( 3 , 4 ). Although medication is effective and necessary in many cases, studies have shown that antidepressants bring about notable side effects ( 11 , 12 ).…”

Multisystemic supports and adolescent resilience to depression over time: A South African mixed methods study

“…While the adversities that are common to sub-Saharan Africa are known to jeopardize adolescent mental health, young people in LMIC countries like South Africa have little if any access to mental health services (Lu et al, 2018; Stelmach et al, 2022). Furthermore, very few studies have documented the incidence of mental illness among sub-Saharan adolescents (Steel et al, 2022).…”