Cost-effectiveness of the Mental Health and Development model for schizophrenia-spectrum and bipolar disorders in rural Kenya
Open accessAbstract
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 11 low- and middle-income countries. METHOD: 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 2 years. The cost per healthy day gained was Int$ 7.96 in the first year and Int$ 1.03 over 2 years - less than the agricultural minimum wage. The cost per disability-adjusted life year averted over 2 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 2 years. Its affordability relies on multi-sectoral participation nationally and internationally.
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The BasicNeeds model, a social intervention that integrates employment with the care and treatment of mental disorders, is cost effective and accessible to community members particularly vulnerable due to their symptoms and poverty.
“The BasicNeeds model, a social intervention that integrates employment with the care and treatment of mental disorders, is cost effective and accessible to community members particularly vulnerable due to their symptoms and poverty 47 70 .”
From Integrated care for people with long-term mental and physical health conditions in low-income and middle-income countries (2019) · cites this paper as [47]
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Hosseini Jebeli, S. S., Rezapour, A., Hajebi, A., Moradi-Lakeh, M., & Damari, B. (2021) · International Journal of Mental Health Systems · doi:10.1186/s13033-021-00468-w · Cited by 10 · see citing works
- Authors
- de Menil, V., Knapp, M., McDaid, D., Raja, S., Kingori, J., Waruguru, M., Wood, S. K., Mannarath, S., & Lund, C.
- Affiliations
- London School of Economics and Political Science (GB)
- University of Cape Town (ZA)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2015-05-21
- Volume
- 45
- Issue
- 13
- Pages
- 2747-2756
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2130436785
- Cited by
- 36
- References
- 38
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 12 · 2022: 9 · 2021: 2 · 2020: 2 · 2018: 1 · 2017: 4 · 2016: 2 · 2015: 2
- FWCI
- 4.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- London School of Economics and Political Science Research Online (London School of Economics and Political Science) (submittedVersion)
- London School of Economics and Political Science Theses Online (London School of Economics and Political Science) (submittedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- LSE Research Online Documents on Economics (submittedVersion)
- Funders
- European Commission
- Department for International Development
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- schizophrenia spectrum disorders, bipolar disorder, community mental health services, cost-effectiveness, rural Kenya, treatment gap, disability-adjusted life years, health system costs, social costs, mental health equity
- MeSH terms
- Adult, Bipolar Disorder, Cost-Benefit Analysis, Female, Humans, Kenya, Male, Mental Health, Middle Aged, Rural Population, Schizophrenia, Health Care Costs, Models, Economic, Quality-Adjusted Life Years
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