Training Course on Health Economics of Mental Health

Module 1: Introduction to Health Economics and Mental Health
Foundations of Health Economics
Principles of scarcity, opportunity cost, efficiency, and equity.
Differences between health economics and general economics.
The Burden of Mental Health Disorders
Global and national prevalence rates of depression, anxiety, schizophrenia, substance use.
Direct costs: hospital care, medications, therapy services.
Indirect costs: lost productivity, unemployment, caregiving burden.
Intangible costs: reduced quality of life, stigma, social exclusion.
Challenges in Mental Health Economics
Underfunding compared to physical health.
Measurement difficulties in mental health outcomes.
Case Study: The global cost of depression and anxiety (WHO/World Bank estimates).
Activity: Group discussion on how stigma contributes to economic underestimation of mental health needs.

Module 2: Economic Evaluation of Mental Health Interventions
Types of Economic Evaluations
Cost-minimization analysis (CMA).
Cost-effectiveness analysis (CEA).
Cost-utility analysis (CUA) – use of QALYs/DALYs.
Cost-benefit analysis (CBA).
Measuring Mental Health Outcomes
Clinical outcomes vs. patient-reported outcomes.
Utility measurement tools (EQ-5D, SF-36, WHOQOL).
Modeling in Mental Health Economics
Decision trees for short-term interventions.
Markov models for chronic conditions like schizophrenia or bipolar disorder.
Sensitivity and scenario analysis.
Practical Applications
Economic evaluations of therapy (CBT, group therapy).
Cost-effectiveness of digital mental health tools (apps, teletherapy).
Exercise: Calculate incremental cost-effectiveness ratio (ICER) for a community-based depression prevention program.

Module 3: Financing Mental Health Services
Current Financing Models
Public financing (tax-based systems, government subsidies).
Private sector financing (insurance, out-of-pocket).
Donor and philanthropic contributions.
Insurance and Reimbursement Challenges
Parity laws and coverage for mental vs. physical health.
Exclusions, limitations, and high copayments.
Integrating Mental Health into UHC
Service coverage and financial protection.
Priority-setting: what services should be included?
Innovative Financing Approaches
Performance-based financing.
Social impact bonds for mental health.
Community-based financing.
Group Activity: Teams design a financing model to scale up a national suicide prevention strategy.
Case Example: Comparing financing for mental health services in high-income vs. low-income countries.

Module 4: Policy, Equity, and Access in Mental Health Economics
Equity Considerations
Rural vs. urban disparities.
Gender, age, and socioeconomic differences.
Marginalized groups (refugees, indigenous communities).
Policy Development and Analysis
Role of economic evidence in shaping national mental health policies.
Policy instruments: regulation, service provision, financing, advocacy.
Barriers to Implementation
Workforce shortages.
Weak governance structures.
Social stigma and lack of awareness.
Ethical and Legal Issues
Protecting vulnerable populations in financing and access.
Balancing cost-effectiveness with human rights.
Case Study: Cost-effectiveness of integrating mental health into primary healthcare systems.
Exercise: Draft a one-page policy recommendation brief on funding community-based psychosocial services.

Module 5: Emerging Trends and Future Directions
Digital Mental Health
Cost-effectiveness of telemedicine and app-based therapy.
Scalability and barriers to adoption.
Workplace Mental Health Economics
Costs of absenteeism, presenteeism, and turnover.
ROI (return on investment) of workplace wellness programs.
Global Health Priorities
Mental health in humanitarian crises.
The role of WHO and World Bank in financing mental health.
Building Investment Cases
Using economic arguments to secure funding for mental health.
Communicating evidence to policymakers and donors.
Capstone Project: Participants develop an economic evaluation and investment case for a mental health intervention of their choice (e.g., digital therapy for youth, school-based program, community-based care).