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Online ISSN: 1099-176X    Print ISSN: 1091-4358
The Journal of Mental Health Policy and Economics
Volume 16, Issue 4, 2013. Pages: 179-186
Published Online: 1 December 2013

Copyright © 2013 ICMPE.


 

Inter-Sectoral Costs and Benefits of Mental Health Prevention: Towards a New Classification Scheme

Ruben M.W.A. Drost,1* Aggie T.G. Paulus,2 Dirk Ruwaard,3 Silvia M.A.A. Evers4

1MSc, Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
2PhD, Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
3MD, PhD, Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
4LLM, PhD, Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands

* Correspondence to: Ruben Drost, Duboisdomein 30, 6200 MD, Maastricht, The Netherlands.
Tel.: +31-43-388 1729
Fax: +31-43-388 4162
E-mail: r.drost@maastrichtuniversity.nl

Source of Funding: This research was supported by Grant 200400010 from the Dutch Organisation for Health Research and Development (ZonMw), The Hague.

Abstract

Many preventive interventions for mental disorders have costs and benefits that spill over to sectors outside the healthcare sector. Little is known about these “inter-sectoral costs and benefits” (ICBs) of prevention. However, to achieve an efficient allocation of scarce resources, insights on ICBs are indispensable. Using PubMed, a literature search was conducted for ICBs of mental disorders and related (psycho)social effects. The ICBs found were classified in one of four sectors: “Education”, “Labor & Social Security”, “Household & Leisure” or “Criminal Justice System”. Psycho(social) effects were placed in a separate section under “Individual & Family”. This resulted in a sector-specific classification scheme for ICBs. In order to validate the scheme’s international applicability inside and outside the mental health domain, semi-structured interviews were conducted with (inter)national experts in the broad fields of health promotion and disease prevention. Based on these interviews, the scheme remained unadjusted, apart from adding a population-based dimension.

Background: Many preventive interventions for mental disorders have costs and benefits that spill over to sectors outside the healthcare sector. Little is known about these “inter-sectoral costs and benefits” (ICBs) of prevention. However, to achieve an efficient allocation of scarce resources, insights on ICBs are indispensable.

Aim of the Study: The main aim was to identify the ICBs related to the prevention of mental disorders and provide a sector-specific classification scheme for these ICBs.

Methods: Using PubMed, a literature search was conducted for ICBs of mental disorders and related (psycho)social effects. A policy perspective was used to build the scheme's structure, which was adapted to the outcomes of the literature search. In order to validate the scheme's international applicability inside and outside the mental health domain, semi-structured interviews were conducted with (inter)national experts in the broad fields of health promotion and disease prevention.

Results: The searched-for items appeared in a total of 52 studies. The ICBs found were classified in one of four sectors: “Education”, “Labor & Social Security”, “Household & Leisure” or “Criminal Justice System”. Psycho(social) effects were placed in a separate section under “Individual & Family”. Based on interviews, the scheme remained unadjusted, apart from adding a population-based dimension.

Discussion: This is the first study which offers a sector-specific classification of ICBs. Given the explorative nature of the study, no guidelines on sector-specific classification of ICBs were available. Nevertheless, the classification scheme was acknowledged by an international audience and could therefore provide added value to researchers and policymakers in the field of mental health economics and prevention.

Implications for Health Policies: The identification and classification of ICBs offers decision makers supporting information on how to optimally allocate scarce resources with respect to preventive interventions for mental disorders.

Implications for Further Research: By exploring a new area of research, which has remained largely unexplored until now, the current study has an added value as it may form the basis for the development of a tool which can be used to calculate the ICBs of specific mental health related preventive interventions.


Received 26 April 2013; accepted 4 October 2013

Copyright 2013 ICMPE