WHO menu of cost-effective interventions for mental health
Overview
Introduction
In 2019, the Seventy-second World Health Assembly requested the WHO Director-General to prepare a menu of policy options and cost-effective interventions for mental health. In 2020 the Seventy-third World Health Assembly noted the completion of the request. The process and results of this work are described in this brief document. The menu of cost-effective interventions for mental health is a list of interventions for which information on cost-effectiveness is available for use by Member States when selecting interventions, as appropriate for their national context. It is not exhaustive; the menu is a preliminary list of population- and individual-level interventions based on current evidence (see Table 1).
Development of the menu
The menu was developed using the WHO-CHOICE methodology to prepare and update, as appropriate, WHO estimates of the cost-effectiveness of a range of mental health interventions, in line with the development of Appendix 3 to the global action plan for the prevention and control of noncommunicable diseases 2013–2020.
WHO-CHOICE is a programme that helps countries to identify priorities based on health impact and cost-effectiveness. It can be applied to a wide range of strategies relevant to policies affecting health outcomes. All options are compared to a common comparator, a null scenario in which the impacts of currently implemented interventions are removed, thereby enabling comparison of interventions across geographical areas and aspects of health.
Since 2001, WHO has used the WHO-CHOICE method to estimate the cost-effectiveness of a range of health interventions. With respect to mental health, this work has focused primarily on assessing individual-level interventions for clinical management of psychosis, bipolar disorder and depression, with results published and disseminated through peer-reviewed academic journals. As part of the preparations of the menu of cost-effective interventions, key data parameters used to analyze the interventions were updated and new cost-effectiveness estimates were generated at the level of country groupings at higher and lower levels of national income. In 2019, to expand the menu of options beyond clinical management, WHO conducted economic analyses of three population level interventions:
- regulatory bans on the use of highly hazardous pesticides in order to reduce cases of suicide,
- universal school-based socio-emotional learning programmes to improve mental health and prevent suicide in adolescents; and
- indicated, school-based socio-emotional learning programmes to improve mental health and prevent suicide in adolescents.
The menu has been compiled from the results of economic analyses, which are available on the WHO website. These analyses assess cost-effectiveness ratios, health impact and the economic costs of implementation. The results translate into a set of parameters for consideration by Member States. Global analyses should, however, be accompanied by local contextualized analyses; other WHO tools, such as the OneHealth Tool, are available to help individual countries to estimate the costs and health impacts of specific interventions in their national context.
