Advancing Mental Health Economics: Insights From the Themed Section

The global burden of mental health conditions is substantial, affecting the quality and length of life of billions of people worldwide and contributing significantly to health-related costs to patients and their families, governments, health systems, and payers.1 Recognizing the urgent need for action on mental health, the World Health Organization has launched a 5-year (2019-2023) special initiative on mental health to address the increasing prevalence of mental health disorders and their profound societal impact.2 Recent data suggest that disability-adjusted life-years attributable to mental disorders in 2019 could represent as much as 16% of global disability-adjusted life-years.1 In the United States, indicators of adolescent mental health have worsened significantly over the past decade, with 40% of high-school students reporting depressive symptoms and a significant increase in the percentage of youth who seriously considered suicide.3 Recent data also point to the negative impact of the COVID-19 pandemic on mental health, with 4 in 10 American adults reporting symptoms of anxiety and depression in early 2021.4 High-quality real-world data and rigorous economic evaluations of interventions to prevent, diagnose, and treat mental health conditions are essential for informing resource allocation decisions and shaping effective policies at both national and global levels.5 The number of publications on the cost-effectiveness of mental health interventions has increased substantially over the past 5 decades; however, mental health economics faces unique methodological challenges (Fig. 1). These include, for example, the complexity of measuring clinical effectiveness, the need to capture indirect costs such as productivity losses, addressing privacy and confidentiality concerns specific to mental health data, and grappling with issues of stigma and health equity for marginalized populations. The societal and caregiver burdens of mental health conditions further complicate economic evaluations, necessitating innovative approaches to data collection and analysis.6