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|Zechmeister, I., Kilian, R., McDaid, D., & MHEEN group (2008). Is it worth investing in mental health promotion and prevention of mental illness? A systematic review of the evidence from economic evaluations. BMC Public Health, 8(1). doi: 10.1186/1471-2458-8-20
|mental health, mental illness, mental health promotion, economic, cost
|Background: While evidence on the cost of mental illness is growing, little is known about the cost-effectiveness of programs in the areas of mental health promotion (MHP) and mental disorder prevention (MDP).
Objective: To systematically identify and assess economic evaluations in both these areas to support evidence based prioritization of resource allocation.
Search Strategies: Health and non-health related bibliographic databases were searched for relevant articles (Medline, PubMed, Embase, CINAHL, PsychINFO, Psyndex, Econlit, ERIC, and NHS EED). The authors conducted a hand search of key journals and an analysis of grey literature.
Selection Criteria: Economic evaluations of programs that address mental health outcome parameters directly, those that address relevant risk factors of mental illness, as well as suicide prevention interventions were included, while evaluations of drug therapies were excluded. Studies in English and German were included.
Data Collection and Analysis: Study characteristics and results were qualitatively summarized.
Main Results: 14 studies fulfilled the inclusion criteria. They varied in terms of topic addressed, intervention used and study quality. Robust evidence on cost-effectiveness is still limited to a very small number of interventions with restricted scope for generalizability and transferability. The most favorable results are related to early childhood development programs.
Conclusion: Prioritization between MHP and MDP interventions requires more country and population-specific economic evaluations. There is also scope to retrospectively add economic analyses to existing effectiveness studies. The nature of promotion and prevention suggests that innovative approaches to economic evaluation that augment this with information on the challenges of implementation and uptake of interventions need further development.
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