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Review
. 2024 Feb 5;34(1):107-113.
doi: 10.1093/eurpub/ckad193.

An investment case analysis for the prevention and treatment of adolescent mental disorders and suicide in England

Angela Jackson-Morris  1 , Christina L Meyer  1 , Antony Morgan  2 , Rachel Stelmach  3 , Leah Jamison  1 , Candace Currie  2
Affiliations
Review

An investment case analysis for the prevention and treatment of adolescent mental disorders and suicide in England

Angela Jackson-Morris et al. Eur J Public Health. .

Abstract

Background: Adolescent mental health (AMH) needs in England have increased dramatically and needs exceed treatment availability. This study undertook a comparative assessment of the health and economic return on investment (ROI) of interventions to prevent and treat mental disorders among adolescents (10-19 years) and examined intervention affordability and readiness.

Methods: Interventions were identified following a review of published and grey literature. A Markov model followed a simulated adolescent cohort to estimate implementation costs and health, education, and economic benefits. Intervention affordability was assessed, comparing annual cost per adolescent with NHS England per capita spending, and an expert panel assessed intervention readiness using a validated framework.

Results: Over 10- and 80-year horizons, interventions to treat mild anxiety and mild depression were most cost-effective, with the highest individual lifetime ROI (GBP 5822 GBP 1 and GBP 257: GBP 1). Preventing anxiety and depression was most affordable and 'implementation ready' and offered the highest health and economic benefits. A priority package (anxiety and depression prevention; mild anxiety and mild depression treatment) would avert 5 million disability-adjusted life-years (DALYS) and achieve an ROI of GBP 15: GBP 1 over 10 years or 11.5 million DALYs (ROI of GBP 55: GBP 1) over 80 years.

Conclusion: The economic benefits from preventing and treating common adolescent mental disorders equivalent to 25% of NHS England's annual spending in 2021 over 10 years and 91% over 80 years. Preventing and early treatment for anxiety and depression had the highest ROIs and strong implementation readiness.

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Figures

Figure 1
Figure 1
The cost per DALY averted in 2021 GBP at 10- and 80-year time horizons for individual adolescent mental health interventions and the priority intervention package. The mild anxiety treatment intervention has the lowest cost per DALY averted over both time horizons while the intervention to treat moderate-severe anxiety has the highest cost per DALY averted over the two time horizons
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