Economic Evaluations of Mental Health Programs for Children and Adolescents in the United States: A Systematic Review

Abstract

The United States spent 201 billion dollars on mental health related concerns in 2013, ranking mental illness as the leading cause of disability and the single largest source of economic burden worldwide. With mental health-related treatment costs and economic burden only projected to rise, there is an increasing need for cost-inclusive evaluations of mental health interventions specific to the United States as economic evaluations across countries are not easily comparable. Thus, this systematic, descriptive review characterized the types of interventions, target populations, and the quality of 9 economic evaluation studies (e.g., cost-effectiveness, cost-benefit) of youth mental health services conducted in the United States from 2003 to 2019. Existing evaluations suggest that certain mental health interventions for youth, among the few that have been formally evaluated, may be cost-effective and cost-beneficial. However, the small number and mixed quality of eligible studies highlights a dearth of rigorously conductedeconomic evaluations on this topic, variability in cost and outcome assessment approaches, as well as the homogenous characteristics of interventions evaluated. Greater standardization is needed to increase confidence in these conclusions and generate a body of meaningful, quality research that has the potential to shape evidence-based mental health policy.