Are psychological therapies for mental health conditions cost effective?

Abstract: There is evidence that people with mental health problems have higher health and social care costs and lower utility/QALYs than people without. In addition, systematic reviews of controlled clinical trials indicate that psychological therapies can be effective additions to usual care. In contrast, the evidence about the cost-effectiveness of psychological therapies is mixed and uncertain. In part this is due to the design of primary studies to measure service use, costs and health benefits that are a major source of data for within trial analyses and decision analytic models. Systematic reviews and meta-analyses of the results of economic evaluations are subject to issues around differences in perspective, range of costs, approach used to measure service and costs as well as the measure of health benefit. This paper presents summarises the methods and results from research to pool data from a series of pragmatic randomised controlled trials that used the same perspective and approach to measuring cost and health benefits of psychological therapy in serious mental illness (eg depression, bipolar disorder and psychosis). Key research questions explored are:

• What are the costs and health benefits of psychological therapy compared to TAU, overall and by type of mental health condition
• What are the key drivers/determinants of costs and health benefits
• How does the cost-effectiveness of psychological therapy vary across sub-groups