Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London WC2A 2AE, United Kingdom; email:
The Finnish Association for Mental Health, 00240 Helsinki, Finland; email:
Annu Rev Public Health. 2019 Apr 1;40:373-389. doi: 10.1146/annurev-publhealth-040617-013629. Epub 2019 Jan 2.
Poor mental health has profound economic consequences. Given the burden of poor mental health, the economic case for preventing mental illness and promoting better mental health may be very strong, but too often prevention attracts little attention and few resources. This article describes the potential role that can be played by economic evidence alongside experimental trials and observational studies, or through modeling, to substantiate the need for increased investment in prevention. It illustrates areas of action across the life course where there is already a good economic case. It also suggests some further areas of substantive public health concern, with promising effectiveness evidence, that may benefit from economic analysis. Financial and economic barriers to implementation are then presented, and strategies to address the barriers and increase investment in the prevention of mental illness are suggested.
心理健康状况不佳会产生深远的经济后果。鉴于心理健康状况不佳的负担,预防精神疾病和促进更好的心理健康的经济意义可能非常重大,但预防措施往往很少受到关注,也很少得到资源。本文描述了经济证据可以发挥的潜在作用,包括通过实验性试验和观察性研究,或通过建模来证实增加预防投资的必要性。它说明了在整个生命过程中有哪些行动领域已经有了很好的经济理由。它还提出了一些进一步具有实质性公共卫生意义、且有希望产生效果证据的领域,这些领域可能受益于经济分析。然后提出了实施过程中的财政和经济障碍,并提出了应对这些障碍和增加预防精神疾病投资的策略。