Investments in Mental Health for Far-Reaching Benefits

Mental health problems are a major contributor to the disease burden across the world and in Ghana. They have a significant impact on individuals through increased disability and mortality, but they also generate substantial costs for Ghana and elsewhere in the form of lost productivity. The costs of poor mental health have been conservatively estimated to account for between 3% and 4% of GDP in developing countries. Globally, the World Economic Forum and the Harvard School of Public Health have estimated the cost of mental illness at US$2.5 trillion every year, with a projected increase to US$6 trillion by 2030.

At an individual level, both patients and their caregivers experience economic costs due to mental health issues. Depression, for example, causes a 50% productivity loss for the patient and 24% for the caregiver. With schizophrenia, the loss in productivity is estimated at 70% for the patient and 30% for the caregiver.

According to WHO estimates, approximately 13% of Ghana’s population suffers from mental disorders, with schizophrenia, substance abuse, and mood disorders being the most common diagnoses. Mental disorders are one of the leading causes of years lived with disability in the country, and it has been predicted that there will be an increase in the number of young people entering the age of risk for onset of certain mental disorders. 

Despite the prevalence and impact of these diseases, mental and neurological disorders often go undiagnosed and untreated, and investment in mental health is less than 1% of the health budget in many countries. In Ghana, the treatment gap for mental health disorders is estimated to be over 98%. Many people do not receive evidence-based care, which leads to chronicity, suffering and increased economic effects. 

Encouraging better mental health through increased screening, early detection and intervention for severe mental disorders, particularly depression and schizophrenia, has the potential to reduce the high social and economic effects for both individuals and society. However, with so many areas competing for the attention of policymakers, it is vital to know where scarce public resources can generate the biggest benefit not only in economic but also social and environmental terms. 

This is the goal of Ghana Priorities, a collaboration between the National Development Planning Commission and the award-winning think tank Copenhagen Consensus that aims to find the most cost-effective policies to improve the lives of all Ghanaians. With the support of numerous ministries, sector experts and stakeholders across all levels of government and society, the researchers have analyzed more than 80 policy proposals to determine where public resources would do the most good for every cedi spent.

On mental health, Justice Nonvignon and Samuel Agyei Agyemang from the School of Public Health at the University of Ghana, Caroline Reindorf Amissah from the Mental Health Authority in Accra, and Brad Wong from Copenhagen Consensus calculated the costs of screening approximately 980,000 people to detect cases of depression, anxiety and schizophrenia, as well as the cost of their treatment, including both medical and non-medical expenses. These costs were then compared to the benefits derived from correctly treating mental disorders.

With depression, the number of Ghanaians projected to be included in the program after screening was estimated at 13,200. Treatment would last two years on average, but 30% of the cases would continue to receive some consultation and medication for life. The total cost of this intervention was estimated at approximately GH￠ 92 million for a period of 10 years, but the benefit for Ghana and especially its economy would be much larger. Through screening and treatment, 112 cases of self-harm and twelve suicides could be prevented each year. The total benefits, including around GH￠ 560 million productivity loss avoided for patients and caregivers, were estimated at GH￠ 630 million, seven times more than the original investment.

For anxiety disorder, the number of Ghanaians projected to receive treatment was estimated at around 11,400, and about 30% would remain on antidepressants for life. The researchers estimated the total cost of this program at approximately GH￠ 88 million, with benefits worth more than GH￠ 400 million. 97 cases of self-harm and nine suicides could be averted every year, as well as an estimated GH￠ 350 million in productivity loss for patients and caregivers. For every cedi spent on treating anxiety, nearly 5 cedi could be gained for society.

Schizophrenia patients would be enrolled in treatment for life, but the number of people the researchers estimated to receive treatment in Ghana is only 667, much lower than the number of patients with depression and anxiety. The projected cost for the schizophrenia program was estimated at approximately GH￠ 28 million and the total benefit at GH￠ 44 million, including patient and caregiver productivity loss as well as five cases of self-harm and one suicide averted per year.

Overall, this research shows that screening and treatment for mental disorders in Ghana contribute to improved health and productivity in patients and caregivers, paving the path toward stronger economic participation and output for both within Ghana's economy.

This article was originally published in Ghana's newspaper of record - The Daily Graphic.