Mental health promotion and mental illness prevention: the economic case

Mental ill health is the largest single cause of disability in the UK, contributing almost 23% of the overall burden of disease compared to about 16% each for cancer and cardiovascular disease. The economic and social costs of mental health problems in England are estimated at around £105 billion each year.

The authors of this report were asked by the Department of Health to identify and analyse the costs and economic pay-offs of a range of interventions in the area of mental health promotion, prevention and early intervention, and to present this information in a way that would most helpfully support NHS and other commissioners in assessing the case for investment.

Health systems aim to improve health and health-related well-being, but are always constrained by the resources available to them. They also need to be aware of the resources available in adjacent systems which can have such an impact on health, such as housing, employment and education. Careful choices therefore have to be made about how to utilise what is available. The report addresses the question of whether investment in the prevention of mental health needs and the promotion of mental wellbeing might represent a good use of available resources.

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    • The results of the economic models presented in the report suggest some general conclusions, including:

    • Value for money Even though the economic modelling is based on conservative assumptions, many interventions are seen to be outstandingly good value for money.
    • Self-financing A number of interventions are self-financing over time, even from the narrow perspective of the NHS alone. However, the scope for ‘quick wins’, in the sense of very short payback periods for the NHS, is relatively limited.
    • Range of impacts Many interventions have a broad range of pay-offs, both within the public sector and more widely (such as through better educational performance, improved employment/earnings and reduced crime).
    • Timescales In some cases the pay-offs are spread over many years. Most obviously this is the case for programmes dealing with childhood mental health problems, which in the absence of intervention have a strong tendency to persist throughout childhood and adolescence into adult life. However, the overall scale of economic pay-offs from these interventions is generally such that their costs are fully recovered within a relatively short period of time.

    The report is the result of collaboration between researchers in the Personal Social Services Research Unit (PSSRU), London School of Economics and Political Science; the Centre for Mental Health (CMH); and the Centre for the Economics of Mental Health (CEMH), Institute of Psychiatry at King’s College London.