Scaling-up treatment of depression and anxiety: a global return on investment analysis

TLDR

Depression and anxiety are highly prevalent, disabling disorders that cause significant health loss and economic output, and ROI analyses show that scaling up treatment offers strong economic and health benefits. The study proposes a global investment case for scaling up treatment of depression and anxiety to address their public health and economic burden. Using the OneHealth mental health module, the authors model a linear increase in treatment coverage with a 5 % improvement in work ability, mapping these gains to labour participation and GDP across 36 countries from 2016 to 2030. The analysis estimates a $147 billion investment yielding $310 billion in net present value, 43 million extra healthy life‑years, and $399 billion in productivity gains, with benefit‑cost ratios ranging from 2.3 to 5.7 to 1.

Abstract

Depression and anxiety disorders are highly prevalent and disabling disorders, which result not only in an enormous amount of human misery and lost health, but also lost economic output. Here we propose a global investment case for a scaled-up response to the public health and economic burden of depression and anxiety disorders.In this global return on investment analysis, we used the mental health module of the OneHealth tool to calculate treatment costs and health outcomes in 36 countries between 2016 and 2030. We assumed a linear increase in treatment coverage. We factored in a modest improvement of 5% in both the ability to work and productivity at work as a result of treatment, subsequently mapped to the prevailing rates of labour participation and gross domestic product (GDP) per worker in each country.The net present value of investment needed over the period 2016-30 to substantially scale up effective treatment coverage for depression and anxiety disorders is estimated to be US$147 billion. The expected returns to this investment are also substantial. In terms of health impact, scaled-up treatment leads to 43 million extra years of healthy life over the scale-up period. Placing an economic value on these healthy life-years produces a net present value of $310 billion. As well as these intrinsic benefits associated with improved health, scaled-up treatment of common mental disorders also leads to large economic productivity gains (a net present value of $230 billion for scaled-up depression treatment and $169 billion for anxiety disorders). Across country income groups, resulting benefit to cost ratios amount to 2·3-3·0 to 1 when economic benefits only are considered, and 3·3-5·7 to 1 when the value of health returns is also included.Return on investment analysis of the kind reported here can contribute strongly to a balanced investment case for enhanced action to address the large and growing burden of common mental disorders worldwide.Grand Challenges Canada.