The economic case for prevention

The Mental Health Foundation, alongside London School of Economics and Political Science researchers, have laid out the economic benefits of investing in prevention of mental health conditions in a new report. Their research has found that poor mental health costs the UK £118 billion per year – however, they say, much of this cost is preventable with investment in early intervention services. 

David McDaid and A-La Park (LSE Care Policy and Evaluation Centre) used the 2019 Institute of Health Metrics and Evaluation Global Burden of Disease (GBD) study in their research which looks at the impact of health conditions – including diagnosed mental health problems. McDaid and Park explored 11 categories of mental health problems, including depressive and anxiety disorders, bipolar affective disorder, schizophrenia, autism spectrum disorders, conduct disorder, ADHD and eating disorders. 

The GBD uses disability-adjusted life years – the sum of the number of years lost due to premature mortality and years lived with a disability – as its main outcome measure. McDaid and Park found that, in 2019, mental health conditions in the UK accounted for 7 per cent of all ill health. Mental health conditions were the fourth leading cause of disability-adjusted life years and were the second leading cause of years lived with a disability. 

The researchers wrote that this amounted to £117.9 billion, or 5 per cent of UK GDP in 2019, mainly due to lost productivity and the costs of unpaid informal carers. 'We believe our estimate is highly conservative as we have not included dementia, nor presenteeism and absenteeism in the workplace, and have not included sub-threshold conditions. We also do not include any additional costs of managing physical health problems in people with mental health conditions. 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 researchers also examined some of the most cost-effective ways to prevent mental health conditions from occurring in the first place. They laid out some of these 'good buys' for investing in prevention across the life span including support in diagnosing and treating perinatal depression, parenting programmes, school anti-bullying programmes, more opportunities for exercise in all age groups, early identification of poor mental health in adults with follow-up psychological therapy, workplace identification of mental health problems – including changing work cultures to promote and protect mental health and brief psychological therapy for those with long-term health problems. 

The authors, who also included Gavin Davidson (Queen's University Belfast), Ann John (Swansea University), and Lee Knifton, Shari McDaid, Alex Morton, Lucy Thorpe, and Naomi Wilson – all from the Mental Health Foundation – made recommendations to increase a focus on prevention. As well as increased investment among devolved nation governments, they recommend using a public health lens to explore ways of preventing mental health problems, building on, and mapping, existing prevention programmes, and supporting research to increase the knowledge base on cost-effective interventions.