The Economic Case for Investing in the Prevention of Mental Health Conditions in the UK

McDaid, David and Park, A-La and Davidson, Gavin and John, Ann and Knifton, Lee and McDaid, Shari and Morton, Alec and Thorpe, Lucy and Wilson, Naomi (2022) The Economic Case for Investing in the Prevention of Mental Health Conditions in the UK. Mental Health Foundation, [London].

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Abstract

This report provides an overview of the economic case for the prevention of mental health conditions. To do this, we first estimated the societal costs of living with mental health conditions in the UK in 2019 and then reviewed what is known about the cost-effectiveness of wellevidenced actions to prevent these mental health conditions. To estimate costs, we used a prevalencebased costing approach. This measures the number of people living with mental health conditions over a specific short time period (usually one year) and estimates the average costs associated with these conditions over this time period. Our prevalencebased costing model makes use of data on prevalence from the 2019 Institute of Health Metrics and Evaluation Global Burden of Disease (GBD) study. The GBD study quantifies the impact of all health conditions, both infectious and non-communicable, including mental health conditions, as well as the impacts on injury, including intentional self-harm. As part of the study, the GBD systematically searches for and assesses mental health surveys around the globe. To allow for comparability in measurement, case definitions used by GBD predominantly adhered to international diagnostic criteria guidance, either the DSM-IV-TR, mainly used in the United States or the ICD-10 criteria used mainly elsewhere, as these are used by the majority of mental health surveys included in the GBD. The GBD study estimates are periodically updated, apply a common methodology, are subject to peer review, and are routinely used by the World Health Organization (WHO) when looking at the global impact of mental health conditions. Furthermore, GBD estimates are provided separately for all four nations of the UK, as well as at English Region level. These estimates are conservative, as the GBD does not include the impact of sub-diagnostic threshold mental health conditions, as well as risk factors such as undue stress which do not fit into diagnostic criteria, all of which will also have economic costs. We included 11 of 12 broad categories of mental disorder meeting diagnosable thresholds used in the GBD1. These were depressive disorders (major depressive disorder and dysthymia), anxiety disorders, bipolar affective disorder, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder (ADHD), eating disorders (anorexia nervosa and bulimia nervosa), and a final category of other mental disorders (which mainly covers personality disorders). A detailed list of conditions is listed in Table A-2 in the appendix. We excluded the idiopathic intellectual disabilities category in the GBD. Neurological conditions such as dementia, as well as alcohol and substance use disorders, are not included. Although not all intentional self-harm is linked with a mental health condition, we also separately provide an estimate of the health and intangible costs associated with intentional self-harm, including suicide, reported in the GBD. All costs are calculated and reported in 2020 pounds sterling.

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