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Update: Economics of Mental Health in Australia

Since its establishment, the National Mental Health Commission has sought to put mental health on the economic agenda. The potential economic and social gains from mental health reform from investing in promotion, prevention and early intervention are considerable.

The Commission is seeking to build on the evidence base of why investing in promotion and prevention initiatives can result in benefits for the individual in terms of their mental health and also economic benefits in the form of improvements in productivity and efficiency.

In 2017, Deakin Health Economics was engaged by the Commission to produce a literature review and scoping study regarding mental health promotion and prevention initiatives in the Australian context. The results of the study were considered at a ‘Best Buys’ stakeholder workshop in March 2018. The outcomes of the workshop informed the Commission’s selection of ten promotion and prevention interventions to be modelled using a return-to-investment framework. A summary of the workshop can be found here.

The interventions selected by the Commission have strong parallels with work completed in the UK and published in 2017 for Public Health England. Interventions for the Australian ‘Best Buys’ were prioritised on the basis of available evidence for clinical effectiveness and cost effectiveness. The interventions were then selected by applying criteria determined by stakeholder attendees at the workshop in March. The criteria which were applied to the interventions included:

  • Scalability - to what extent can an intervention be realistically rolled out across all population groups who would benefit, and feasibility of maintaining program quality and fidelity at scale?
  • Sustainability - what is the financial cost of scaling up, and what is the longevity of outcomes likely to be beyond the interventions?
  • Opportunity Costs - what are the trade-offs, including workforce demands and re-direction of resources from other programs and/or policies?
  • Needs Based - with a focus on potential ‘burden of disease’, noting the priority is prevention and promotion of mental health.
  • Acceptability - what is the likelihood that individuals in the target population will accept the intervention, and what is the likelihood of generating ‘buy-in’ from policy decision makers?
  • Unanticipated Consequences - both positive and negative including accrual of downstream benefits and those across different sectors/portfolios.

 Details of the ten interventions are in the table below.

Intervention Number

Intervention Description


Workplace based psychological interventions for general promotion of mental health


E-health psychological workplace intervention for increased psychological wellbeing and work effectiveness


Physical activity interventions for treatment of post/pre-natal depression.


Psychological interventions for prevention of post/pre-natal depression.


Psychological interventions for treatment  of bullying


Parenting interventions for prevention of mental disorders or mental health promotion


Psychological interventions for the treatment of depression in school settings


E-health for prevention of depression/anxiety in young people.


Educational intervention to reduce older persons' loneliness


E-health intervention to reduce older person’s loneliness

This modelling will be completed by Deakin Health Economics and will be supported by a Steering Committee to provide independent and expert advice on both the interventions and the modelling process. The project is expected to run from July 2018 to June 2019, with outcomes published progressively over this period.


The National Mental Health Commission issued a media release about the Economics of Mental Health in Australia.

Media Release

National Mental Health Commission Initiatives

Economics of Mental Health in Australia Symposium

Economics of Mental Health in Australia Workshop

Economics of Mental Health Resources

Below are some of the many references that have been identified in the Commission’s work so far around the economics of mental health.

Please note this is not intended to be an exhaustive list of materials, but rather a sample of the substantial work in this area both in Australia and internationally.

Behavioural insights team

NSW Department of Premier and Cabinet


Victorian Department of Premier and Cabinet


Commonwealth Department of Prime Minister and Cabinet


United Kingdom Cabinet Office


Childhood bullying victimisation is associated with use of mental health services over 5 decades: a longitudinal nationally-representative cohort study


Adult Health Outcomes of Childhood Bullying Victimization: Evidence From a Five-Decade Longitudinal British Birth Cohort

Burden of disease

Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010

Costing/Cost of illness/cost-effectiveness

Cost-effectiveness of computerised cognitive behavioural therapy for anxiety and depression in primary care: randomised controlled trial


Financial cost of social exclusion: follow up study of antisocial children into adulthood


Cost of depression among adults in England in 2000


The costs and benefits of interventions in the area of mental health: a rapid review


The evidence on the costs and impacts on the economy and productivity due to mental ill health: a rapid review.


The cost of mental health and substance abuse services in Canada.


Investing in recovery: Making the business case for effective interventions for people with schizophrenia and psychosis.

Determinants, Dynamics and Consequences of Mental Illness

Financial decision-making in the household: Exploring the importance of survey respondent, health, cognitive ability and personality


Long-term health effects of Vietnam-era military service: A quasi-experiment using Australian conscription lotteries


Child mental health and educational attainment: Multple observers and the measurement error problem


The effect of mental health on employment: Evidence from Australian panel data


The income gradient in childhood mental health: all in the eye of the beholder?


Exploring the intergenerational persistence of mental health: Evidence from three generations

Early intervention, promotion & prevention

Mental health promotion and mental illness prevention: The economic case


Prevention: wrestling with new economic realities. Tizard learning disability review


National Research Council and Institute of Medicine 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities (register to download PDF)


Committee on the Prevention of Mental Disorders and Substance Abuse Among Children, Youth, and Young Adults: Research Advances and Promising Interventions

Economic hardship

The Mental Health Consequences of the Recession: Economic Hardship and Employment of People with Mental Health Problems in 27 European Countries


The economic case for better mental health


Public health economics: a systematic review of guidance for the economic evaluation of public health interventions and discussion of key methodological issues


Political and Institutional Influences on the Use of Evidence in Public Health Policy


The UK National Institute for Health and Care Excellence (provides guidance, advice, quality standards and information services for health, public health and social care).

Housing & homelessness

Mental health and housing: Potential economic benefits of improved transitions along the acute care pathway to support recovery for people with mental health needs


Clinical efficacy of computerised cognitive behavioural therapy for anxiety and depression in primary care: randomised controlled trial


Can we model a cognitive footprint of interventions and policies to help to meet the global challenge of dementia?

Mental wealth

Foresight Mental Capital and Wellbeing Project 2008. Final Project report


How's Life? Measuring well-being


Community Wellbeing From the Ground Up: A Yawuru example


Mental Well-being Impact Assessment


Community Capital - The Value of Connected Communities


The mental wealth of nations

Outcomes and evaluation

Policy advice and Treasury's Wellbeing Framework


Guide to Evaluation in Health Research


The Magenta Book: Guidance for Evaluation


Persistent and contemporaneous effects of job stressors on mental health: a study testing multiple analytic approaches across 13 waves of annually collected cohort data


Patient reported outcome measures in practice


Understanding controlled trials. Why are randomised controlled trials important?


How do you know which health care effectiveness research you can trust? A guide to study design for the perplexed


The Implications for Health, Depression, and Life Satisfaction from a Permanent Increase in Income for the Disadvantaged Elderly: Evidence from Taiwan


Early Childhood Investments Substantially Boost Adult Health


The impact of Beyondblue: the national depression initiative on the Australian public’s recognition of depression and beliefs about treatments


Trends in mental illness related public stigma among the English population in 2003-2013: influence of the Time to Change anti-stigma campaign


Economic evaluation of the anti-stigma social marketing campaign in England 2009-2011


Evaluation of the individual budgets pilot programme


The costs of perinatal mental health problems


Perinatal depression and child development: exploring the economic consequences from a South London cohort


Lifetime costs of perinatal anxiety and depression

Quality of Life / Preferences

Women’s Preferences for Treatment of Perinatal Depression and Anxiety: A Discrete Choice Experiment


Measuring the Sensitivity and Construct Validity of 6 Utility Instruments in 7 Disease Areas


Deriving population norms for the AQoL-6D and AQoL-8D multi-attribute utility instruments from web-based data


Comparing and explaining differences in the magnitude, content, and sensitivity of utilities predicted by the EQ-5D, SF-6D, HUI 3, 15D, QWB, and AQoL-8D multiattribute utility instruments


Modelling utility weights for the Assessment of Quality of Life


Assessing outcomes for cost-utility analysis in depression: comparison of five multi-attribute utility instruments with two depression-specific outcome measures

Resource allocation

Investing in recovery: Making the business case for effective interventions for people with schizophrenia and psychosis

Return on investment

Social Return on Investment (SROI) methodology to account for value for money of public health interventions: a systematic review


Return on Investment: Mental Health Promotion and Mental Illness Prevention


Scaling-up treatment of depression and anxiety: a global return on investment analysis


Social Return on Investment: Lessons learned in Australia


Suicides associated with the 2008-10 economic recession in England: time trend analysis


Impact of 2008 global economic crisis on suicide: time trend study in 54 countries



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