Cost-effectiveness of the mental health and development model for schizophrenia-spectrum and bipolar disorders in rural Kenya

Victoria de Menil, Martin Knapp, David McDaid, Shoba Raja, Joyce Kingori, Milka Waruguru, Sarah Kippen Wood, Saju Mannarath and Crick Lund

LSE Research Online Documents on Economics from London School of Economics and Political Science, LSE Library

Abstract: Background. The treatment gap for serious mental disorders across low-income countries is estimated to be 89%. The model for Mental Health and Development (MHD) offers community-based care for people with mental disorders in eleven low- and middle-income countries. Methods. In Kenya, using a pre-post design, 117 consecutively enrolled participants with schizophrenia-spectrum and bipolar disorders were followed-up at 10 and 20 months. Comparison outcomes were drawn from the literature. Costs were analysed from societal and health system perspectives. Results. From the societal perspective, MHD cost Int$ 594 per person in the first year and Int$ 876 over two years. The cost per healthy day gained was Int$ 7.96 in the first year and Int$ 1.03 over two years – less than the agricultural minimum wage. The cost per DALY averted over two years was Int$ 13.1 and Int$ 727 from the societal and health system perspectives, respectively – on par with antiretrovirals for HIV. Conclusions. MHD achieved increasing returns over time. The model appears cost-effective and equitable, especially over two-years. Its affordability relies on multi-sectoral participation nationally and internationally.

Keywords: Africa; community mental health; economic outcomes; global mental health; severe mental disorders (search for similar items in EconPapers)
JEL-codes: J1 (search for similar items in EconPapers)
Date: 2015-05-21
New Economics Papers: this item is included in nep-hea
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Published in Psychological Medicine, 21, May, 2015, 45(12), pp. 2747-2756. ISSN: 0033-2917

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