The FINANCIAL -- Every US$ 1 invested in scaling up treatment for depression and anxiety leads to a return of US$ 4 in better health and ability to work, according to a new WHO-led study which estimates, for the first time, both the health and economic benefits of investing in treatment of the most common forms of mental illness globally. The study, published on April 13 in “The Lancet Psychiatry”, provides a strong argument for greater investment in mental health services in countries of all income levels.
“We know that treatment of depression and anxiety makes good sense for health and wellbeing; this new study confirms that it makes sound economic sense too,” said Dr Margaret Chan, Director-General of WHO. “We must now find ways to make sure that access to mental health services becomes a reality for all men, women and children, wherever they live.”
Depression and anxiety are increasing
Common mental disorders are increasing worldwide. Between 1990 and 2013, the number of people suffering from depression and/or anxiety increased by nearly 50%, from 416 million to 615 million. Close to 10% of the world’s population is affected, and mental disorders account for 30% of the global non-fatal disease burden. Humanitarian emergencies and ongoing conflict add further to the need for scale-up of treatment options. WHO estimates that, during emergencies, as many as 1 in 5 people are affected by depression and anxiety.
Returns on investment in treatment far outweigh the costs
The new study calculated treatment costs and health outcomes in 36 low-, middle- and high-income countries for the 15 years from 2016-2030. The estimated costs of scaling up treatment, primarily psychosocial counselling and antidepressant medication, amounted to US$ 147 billion. Yet the returns far outweigh the costs. A 5% improvement in labour force participation and productivity is valued at US$ 399 billion, and improved health adds another US$ 310 billion in returns.
However, current investment in mental health services is far lower than what is needed. According to WHO’s “Mental Health Atlas 2014” survey, governments spend on average 3% of their health budgets on mental health, ranging from less than 1% in low-income countries to 5% in high-income countries.
“Despite hundreds of millions of people around the world living with mental disorders, mental health has remained in the shadows,” said Jim Yong Kim, President of the World Bank Group. “This is not just a public health issue — it’s a development issue. We need to act now because the lost productivity is something the global economy simply cannot afford.”
Finance and development actors meet to consider scale-up
A series of events, being co-hosted by the World Bank and WHO on 13-14 April, as part of the World Bank Group-International Monetary Fund Spring Meetings in Washington DC, is bringing ministers of finance, development agencies, academic experts and practitioners together to discuss how to put mental health at the centre of the health and development agenda globally and in countries. The event aims to kick-start an increase in investments in mental health: investments by governments, development agencies and civil society. It also includes an Innovations Fair showcasing feasible, affordable and cost-effective ways to improve mental health care around the world.
During the events, countries which have been successful in scaling up mental health care will present the challenges they faced and how they were overcome. Examples include: Brazil, which has developed a psychosocial care network; Ethiopia, which is rapidly scaling-up training and provision of mental health care across the country; and South Africa, where mental health care and treatment form an integral component of the country’s re-engineered primary health care system.
“Mental health needs to be a global humanitarian and development priority — and a priority in every country,” said Arthur Kleinman, Professor of Medical Anthropology and Psychiatry at Harvard University and an expert on global mental health. “We need to provide treatment, now, to those who need it most, and in the communities where they live. Until we do, mental illness will continue to eclipse the potential of people and economies.”
Scaling up mental health services will contribute to achievement of 1 of the targets of the Sustainable Development Goals, endorsed at the United Nations General Assembly in 2015: by 2030, to reduce by one third premature mortality from noncommunicable diseases through prevention and treatment and promote mental health and well-being.