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

Abstract

Background: No systematic attempt has been made to calculate the costs of scaling up mental health services in low-and middle-income countries. Aims: To estimate the expenditures needed to scale up the delivery of an essential mental healthcare package over a 10-year period (2006-2015). Method: A 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. Results: The cost per capita of providing the core package at target 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. Conclusions: Although significant new resources need to be invested, the absolute amount is not large when considered atthe population level and against other health investment strategies.