Cost of scaling up mental healthcare in low-and middle-income countries

Abstract

BackgroundNo systematic attempt has been made to calculate the costs of scaling up mental health services in low-and middle-income countries.AimsTo estimate the expenditures needed to scale up the delivery of an essential mental healthcare package over a 10-year period (2006–2015).MethodA core package was defined, comprising pharmacological and/or psychosocial treatment of schizophrenia, bipolar disorder, depression and hazardous alcohol use. Current service levels in 12 selected low-and middle-income countries were established using the WHO–AIMS assessment tool. Target-level resource needs were derived from published need assessments and economic evaluations.ResultsThe cost per capita of providing the core package attarget coverage levels (in US dollars) ranged from $1.85 to $2.60 per year in low-income countries and $3.20 to $6.25 per year in lower-middle-income countries, an additional annual investment of $0.18–0.55 per capita.ConclusionsAlthough significant new resources need to be invested, the absolute amount is not large when considered at the population level and against other health investment strategies.