Hostname: page-component-7b9c58cd5d-nzzs5 Total loading time: 0 Render date: 2025-03-14T15:35:25.161Z Has data issue: false hasContentIssue false
  • English
  • Français

Cost-benefit analysis of psychological therapy

Published online by Cambridge University Press:  26 March 2020

R. Layard ,
D. Clark ,
M. Knapp  and
G. Mayraz
R. Layard*
Affiliation:
Centre for Economic Performance, London School of Economics
D. Clark
Affiliation:
Centre for Economic Performance, London School of Economics
M. Knapp
Affiliation:
Centre for Economic Performance, London School of Economics
G. Mayraz
Affiliation:
Centre for Economic Performance, London School of Economics
*
e-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

At present six million people are suffering from clinical depression or anxiety disorders, but only a quarter of them are in treatment. NICE Guidelines prescribe the offer of evidence-based psychological therapy, but they are not implemented, due to lack of therapists within the NHS. We therefore estimate the economic costs and benefits of providing psychological therapy to people not now in treatment. The cost to the governement would be fully covered by the savings in incapacity benefits and extra taxes that result from more people being able to work. On our estimates, the cost could be recovered within two years - and certainly within five. And the benefits to the whole economy are greater still. This is not because we expect the extra therapy to be targeted especially at people with problems about work. It is because the cost of the therapy is so small (£750 in total), the recovery rates are so high (50 per cent) and the cost of a person on IB is so large (£750 per month). These findings strongly reinforce the humanitatian case for implementing the NICE Guidelines. Current proposals for doing this would require some 8,000 extra psychological therapists withing the NHS over the six years.

Keywords

Depressionanxietycost-benefit analysiscognitive behavioural therapypsychological therapistsH5I1
Type
Articles
Information
National Institute Economic Review , Volume 202 , October 2007 , pp. 90 - 98
Copyright
Copyright © 2007 National Institute of Economic and Social Research

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

This study has been funded by the Care Services Improvement Partnership.

References

Bell, S., Clark, D., Knapp, M., Layard, R. Lord, Meacher, M.C., Priebe, S., Thornicroft, G., Turnberg, L.A. and Wright, B. (2006), The Depression Report A New Deal for Depression and Anxiety Disorders, London, London School of Economics.Google Scholar
Boardman, J. and Parsonage, M. (2007), Delivering the Government's Mental Health Policies: Services, Staffing and Costs, The Sainsbury Centre for Mental Health.Google Scholar
Chilvers, C., Dewey, M., Fielding, K., Gretton, V., Miller, P., Palmer, B., Weller, D., Churchill, R., Williams, I. and Bedi, N.et al. (2001), ‘Antidepressant drugs and generic counselling for treatment of major depression in primary care: randomised trial with patient preference arms’, British Medical Journal, 322, 7289, p. 772.CrossRefGoogle ScholarPubMed
Curtis, L., and Netten, A. (2006), Unit Costs of Health and Social Care, University of Kent, Canterbury, Personal Social Services Research Unit.Google Scholar
Fava, G. A., Ruini, C., Rafanelli, C., Finos, L., Conti, S. and Grandi, S. (2004), ‘Six-year outcome of cognitive behavior therapy for prevention of recurrent depression’, American Journal of Psychiatry, 161, 10, pp. 1872–6.CrossRefGoogle ScholarPubMed
Gillespie, K., Duffy, M., Hackmann, A. and Clark, D.M. (2002), ‘Community based cognitive therapy in the treatment of posttraumatic stress disorder following the Omagh bomb’, Behavioural Research Therapy, 40, 4, pp. 345–57.CrossRefGoogle ScholarPubMed
Greenberg, P.E., Kessler, R.C., Birnbaum, H.G., Leong, S.A., Lowe, S.W., Berglund, P.A. and Corey-Lisle, P.K. (2003), ‘The economic burden of depression in the United States: how did it change between 1990 and 2000?’, Journal of Clinical Psychiatry, 64, pp. 1465–75.Google ScholarPubMed
Greenberg, P.E., Stiglin, L.E., Finkelstein, S.N. and Berndt, E.R. (1993), ‘The economic burden of depression in 1990’, Journal of Clinical Psychiatry, 54, 12, pp. 405–18.Google ScholarPubMed
Hahlweg, K., Fiegenbaum, W., Frank, M., Schroeder, B. and von Witzleben, I. (2001), ‘Short-and long-term effectiveness of an empirically supported treatment for agoraphobia’, Journal of Consulting and Clinical Psychology, 69, 3, pp. 375–82.CrossRefGoogle ScholarPubMed
Lincoln, T.M., Rief, W., Hahlweg, K., Frank, M., von Witzleben, I., Schroeder, B. and Fiegenbaum, W. (2003), ‘Effectiveness of an empirically supported treatment for social phobia in the field’, Behaviour Research and Therapy, 41, 11, pp. 1251–69.CrossRefGoogle ScholarPubMed
Marks, I.M., Mataix-Cols, D., Kenwright, M., Cameron, R., Hirsch, S. and Gega, L. (2003), ‘Pragmatic evaluation of computer-aided self-help for anxiety and depression’, The British Journal of Psychiatry, 183, I, pp. 57–65.CrossRefGoogle ScholarPubMed
Mintz, J., Mintz, L.I., Arruda, M.J. and Hwang, S. (1992), ‘Treatments of depression and the functional capacity to work’, Archives of General Psychiatry, 49, 10, pp. 761–8.CrossRefGoogle ScholarPubMed
Nimnuan, C., Hotopf, M. and Wessely, S. (2001), ‘Medically unexplained symptoms: an epidemiological study in seven specialities’, Journal of Psychosomatic Research, 51, 1, pp. 361–7.CrossRefGoogle ScholarPubMed
Paykel, E.S., Scott, J., Teasdale, J.D., Johnson, A.L., Garland, A., Moore, R., Jenaway, A., Cornwall, P.L., Hayhurst, H. and Abbott, R. (1999), ‘Prevention of relapse in residual depression by cognitive therapy’, Archives of General Psychiatry, 56, 9, pp. 829–35.CrossRefGoogle ScholarPubMed
Persons, J.B., Roberts, N.A., Zalecki, C.A. and Brechwald, W.A. (2006), ‘Naturalistic outcome of case formulation-driven cognitive-behavior therapy for anxious depressed outpatients’, Behaviour Research and Therapy, 44, 7, pp. 1041 -51.CrossRefGoogle ScholarPubMed
Revicki, D.A. and Wood, M. (1998), ‘Patient-assigned health state utilities for depression-related outcomes: differences by depression severity and antidepressant medications’, Journal of Affective Disorders, 48, 1, pp. 25–36.CrossRefGoogle ScholarPubMed
Rollman, B.L., Belnap, B.H., Mazumdar, S., Houck, P.R., Zhu, F., Gardner, W., Reynolds, C.F. III, Schulberg, H.C. and Shear, M.K. (2005), ‘A randomized trial to improve the quality of treatment for panic and generalized anxiety disorders in primary care’, Archives of General Psychiatry, 62, 12, p. 1332.CrossRefGoogle ScholarPubMed
Simon, G.E., Revicki, D., Heiligenstein, J., Grothaus, L., VonKorff, M., Katon, W.J. and Hylan, T.R. (2000), ‘Recovery from depression, work productivity, and health care costs among primary care patients’, General Hospital Psychiatry, 22, 3, pp. 153–62.CrossRefGoogle ScholarPubMed
van Schaik, D.J.F., Klijn, A.F.J., van Hout, H.P.J., van Marwijk, H.W.J., Beekman, A.T.F., de Haan, M. and van Dyck, R. (2004), ‘Patients’ preferences in the treatment of depressive disorder in primary care’ General Hospital Psychiatry, 26, 3, pp. 184–9.CrossRefGoogle ScholarPubMed
Wade, W.A., Treat, T.A. and Stuart, G.L. (1998), ‘Transporting an empirically supported treatment for panic disorder to a service clinic setting: a benchmarking strategy’, Journal of Consulting and Clinical Psychology, 66, 2, pp. 231–9.CrossRefGoogle ScholarPubMed
Wells, K.B., Sherbourne, C., Schoenbaum, M., Duan, N., Meredith, L., Unützer, J., Miranda, J., Carney, M.F. and Rubenstein, L.V. (2000), ‘Impact of disseminating quality improvement programs for depression in managed primary care’, Journal of the American Medical Association, 283, 2, pp. 212–20.Google ScholarPubMed