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Making the long-term economic case for investing in mental health to contribute to sustainability
- Author:
- MCDAID David
- Publisher:
- European Union. Directorate General for Health and Consumers
- Publication year:
- 2011
- Pagination:
- 27p.
- Place of publication:
- Brussels
One in four EU citizens can expect to experience a mental health problem during their lifetimes; with up to 10% of the European population experience some type of depressive or anxiety related disorder every year, with women experiencing much higher rates than men. Poor mental health has a significant economic impact on the health system and the wider economy in Europe, with implications for the potential achievement of the Europe 2020 strategy on economic growth. This report considers what is known about the potential short, mid and longer term economic benefits of actions across the life course focused on mental health promotion, mental disorder prevention and early intervention. Actions that can be undertaken both within and external to the mental health system are highlighted, drawing on recent economic analyses prepared in a UK context, supplemented by data from other parts of Europe and elsewhere. The most attractive actions include early actions in childhood which can have substantial benefits that last well into adulthood, as well as interventions to promote health in workplaces. Improved job retention rates reduce the need to pay social welfare payments related to employment and disability. Workplace health promotion activities might also reduce the risk of early retirement due to poor mental health.
Estimating the costs of informal care for people with Alzheimer's disease: methodological and practical challenges
- Author:
- MCDAID David
- Journal article citation:
- International Journal of Geriatric Psychiatry, 16(4), April 2001, pp.400-405.
- Publisher:
- Wiley
In Alzheimer's disease and related disorders estimates of informal care costs have been neglected and when included in cost of illness studies, valuations have been highly variable. This illustrates the need to standardise the methodology not only for valuing formal, but also informal care costs. Methods used for valuing informal care are identified, together with theoretical and practical challenges in measurement. In particular the measurement of time and it's associated satisfaction or utility is complex and valuations of time need to consider aspects of the caregiving experience which influence the marginal valuation of the time spent caring. Argues that more empirical work is required to elicit information on both the positive and negative satisfaction associated with caregiving and to incorporate this into valuations of the costs related to informal care.
The economic case for investing in the prevention of mental health conditions in the UK
- Authors:
- MCDAID David, PARK A-La
- Publisher:
- Mental Health Foundation
- Publication year:
- 2022
- Pagination:
- 114
- Place of publication:
- London
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 well-evidenced actions to prevent these mental health conditions. We have estimated the annual costs of mental health conditions in the UK to be almost £118 billion, with the majority of costs falling outside the health care sector, most notably through lost employment and informal care costs. We also found that including health and quality of life impacts associated with self-harm and suicide, much of which are linked with mental health conditions, would increase these costs to more than £125 billion per annum. The report demonstrates the success of initiatives such as parenting programmes, anti-bullying programmes, and workplace support. Not only are people supported to have good mental health, but there are significant cost savings. For example, one study found that for every £1 spent on parenting programmes, £9.30 could be saved in the long-term, through costs saved to the health, education and criminal justice sectors. Although the evidence base on cost-effectiveness of preventive actions is growing, UK and devolved administrations should support research to increase knowledge about cost-effective interventions. Specific knowledge gaps that can be explored include the impacts of structural interventions such as action on child poverty, as well as measures to reduce inequalities in access and uptake of cost-effective prevention initiatives. (Edited publisher abstract)
Side by Side evaluation: economic analysis
- Authors:
- MCDAID David, PARK A-La
- Publisher:
- London School of Economics and Political Science. Personal Social Services Research Unit
- Publication year:
- 2017
- Pagination:
- 47
- Place of publication:
- London
This report presents findings of the economic analysis of an evaluation of the Side by Side peer support programme, which aimed to increase the availability of peer support for people experiencing mental health problems. The report also summarises key conclusions from a literature review on the cost effectiveness of peer support and explores some of the uncertainties around both the effectiveness and costs of peer support by looking at specific scenarios using a decision modelling approach. Key findings from the literature review confirm that there is little information on the cost effectiveness of peer support in the published literature, most of which is not from a UK context. Analysis of experience in Side by Side suggests that it may have a favourable impact on future costs, with improvements in mean quality life scores compared to baseline. The results of the analysis suggest that peer support can be cost effective and in some cases potentially cost saving, depending on the costs of delivering peer support. Finally, it highlights the importance of capturing the full value of the time and resources volunteered in peer support and not just paid inputs. Potentially, the reciprocal contributions of all involved in peer support will also create valuable additional components of any local mental health system. (Edited publisher abstract)
Growth in the use of early intervention for psychosis services: an opportunity to promote recovery amid concerns on health care sustainability
- Authors:
- MCDAID David, et al
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2016
- Pagination:
- 73
- Place of publication:
- London
Provides a snapshot of the availability of early intervention (EI) services for psychosis in selected European countries that cover different funding and health system structures: predominantly tax funded systems (England, Denmark, Norway, Italy and Spain); mixed tax and social health insurance systems (France and Ireland) and social health insurance systems (Germany). These findings are also put within the context of what is known about the availability of these services in a global context, focusing on experience in the largely publicly funded health care systems found in Australia and Canada. It considers how the maturity and availability of EI services may be associated with the way in which health care services are funded, as well as with the availability of existing health and other public service infrastructure and key enablers of service development. The latter includes exploring links with primary care and non-mental health specialist services. It also looks at the complexity of EI services and how these compare with recommendations on key components of EI care. The report concludes that there is an opportunity to rethink care pathway models for psychosis, putting a greater emphasis on investment early intervention, and suggests that the financial pressures on health systems should be seen as an opportunity to make a compelling case for investment in early intervention. (Edited publisher abstract)
Mental health and housing: potential economic benefits for improved transitions along the acute care pathway to support recovery for people with mental health needs
- Authors:
- MCDAID David, PARK A-La
- Publisher:
- London School of Economics. Personal Social Services Research Unit
- Publication year:
- 2016
- Pagination:
- 18
- Place of publication:
- London
This brief paper looks at some of potential economic benefits that may be realised through the inclusion of housing services as part of the acute care recovery pathway for people with mental health problems. The paper identifies some potential opportunities for freeing up resources from inpatient care which might then be used to invest in alternative community and residential support services that may be provided by or supported by housing organisations. The paper provides a brief background on the acute care pathway and possible areas where economic efficiencies can be made. It then looks briefly at some current trends in the provision of mental health services and their implications for further potential economic efficiencies. It then describes and quantifies some of the potential benefits of reduced use of specialist acute inpatient care services and identify potential opportunities for the housing sector. The report estimates that if all delayed discharges could be eliminated, with appropriate care for this time provided in other forms of supported accommodation net resources of more than £54 million might be freed up for alternative use within the mental health system. These resource savings would be greater if individuals are able to move to even more independent living arrangements. (Edited publisher abstract)
Prescription for success: how housing can make the economic case to health
- Authors:
- MCDAID David, et al
- Publisher:
- National Housing Federation
- Publication year:
- 2014
- Pagination:
- 35
- Place of publication:
- London
A guide to support housing associations’ offer to health, enabling them to build a robust business case to commissioners and become a crucial part of the future of the NHS. Through developing innovative community-based services, housing has a vital role to play in reducing the demand on acute health services and tackling health inequalities. This guide, created in partnership with the London School of Economics, explains how the health economy works, and what commissioners are looking for, including the kind of evidence they expect to see from prospective providers. Housing association case studies of initiatives that have successfully attracted investment have been added as examples of what works. Top tips covered in detail in the guide include: be clear about the offer; find out what works in health; focus on quality rather than cost reduction; be transparent about impact; and accept that change takes time. (Edited publisher abstract)
Making the case for investing in child and adolescent mental health: how can economics help?
- Authors:
- MCDAID David, et al
- Journal article citation:
- International Journal of Mental Health Promotion, 12(4), November 2010, pp.37-44.
- Publisher:
- Taylor and Francis
The promotion of good mental health in European children and young people is essential as a preventative measure against the later emergence of poor mental health. This paper examines the issues to consider in making the economic case for investing in child and adolescent mental well-being promotion and prevention of mental disorder. The paper examines the cost of inaction, asking how economics can highlight some of the consequences of poor child and adolescent mental health. It details the cost of action, quantifying the costs of investing in appropriate interventions. The cost effectiveness of such action is then highlighted, with the suggestion that economic evaluation can help make the case for investing in child and adolescent mental health. Finally, the paper asks which economic, and other incentives, can encourage more use of those interventions that are thought to be cost-effective, and less use of those interventions which are not. The paper concludes with a discussion of how the evidence base can be further strengthened and fed into policy and practice processes across Europe
Making an economic case for prevention and promotion
- Authors:
- KNAPP Martin, MCDAID David
- Journal article citation:
- International Journal of Mental Health Promotion, 11(3), August 2009, pp.49-56.
- Publisher:
- Taylor and Francis
The paper briefly describes the methods of cost-effectiveness and related analyses, and then discusses their potential in relation to promotion of well-being (particularly for children and in the workplace), early intervention services for psychosis and suicide prevention strategies.
Making the economic case for the promotion of mental well-being and the prevention of mental health problems
- Authors:
- MCDAID David, et al
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2008
- Pagination:
- 17p., bibliog.
- Place of publication:
- London
This report begins by asking why there should be investment in promotion and prevention. It then summarises what is known and gives examples of study findings on wellbeing, early intervention, depression, suicide and workplace health promotion. Ongoing and future evaluations are noted and the need for more European assessments emphasised.