Cost of scaling up mental healthcare in low- and middle-income countries.
BACKGROUND
No systematic attempt has been made to calculate the costs of scaling up mental health services in low- and middle-income countries.


OBJECTIVE
To estimate the expenditures needed to scale up the delivery of an essential mental healthcare package over a 10-year period (2006-2015).


METHODS
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 $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 at the population level and against other health investment strategies.
Department of Health Systems Financing (HSF), World Health Organization, 1211 Geneva, Switzerland. ChisholmD@who.int
Dan
D
Chisholm
Crick
C
Lund
Shekhar
S
Saxena
D003365:Costs and Cost Analysis; D005260:Female; D014943:Global Health; D006295:Health Resources / Q000191:economics* / Q000600:supply & distribution; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000628:therapy; D008605:Mental Health Services / Q000191:economics* / Q000600:supply & distribution; D012106:Research; D000078329:Workforce