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RTI study identifies cost-effective intervention recommendations to address mental health needs among adolescents in England

Research highlights the need for prevention and early treatment of anxiety and depression  


RESEARCH TRIANGLE PARK, N.C. – A new study led by experts from RTI International, a nonprofit research institute and leading international development organization, sheds light on the critical importance of addressing adolescent mental health (AMH) needs in England.  

RTI’s Angie Jackson-Morris, Ph.D., Christina Meyer, and Rachel Stelmach collaborated with adolescent health experts at Glasgow Caledonian University London and consulted with stakeholders with an interest in adolescent mental health from a range of sectors. The study has now been published in the European Journal of Public Health. The paper provides what is understood to be the first comprehensive comparative assessment of the health and economic return on investment (ROI) of interventions designed to prevent and treat mental disorders among adolescents aged 10-19. Notably, the research also examines the affordability and readiness of these interventions, offering valuable insights for policymakers and healthcare professionals grappling with the escalating AMH crisis.

“Adolescent mental health is a major and growing concern in England, the wider UK, and many countries globally,” said Jackson-Morris. “This study identifies the critical need to invest in cost-effective ‘upstream’ interventions to prevent and provide early treatment for common mental health issues such as depression and anxiety. Not only will this improve young people’s health and wellbeing and life outcomes, it will reduce the prevalence of severe and chronic conditions and the substantial associated economic costs.”

One in eight young people aged 5-19 in England experienced a mental disorder in 2017, and hospital admissions for self-harm among ages 9-17 increased sharply between 2020-2022. The study highlights extensive waiting times for diagnosis and treatment, insufficient capacity, and an urgent need for prevention and early treatment programs in schools, the community, and health sector. The COVID-19 pandemic and associated challenges further increased demand and strained resources.

Interventions were identified through review of literature, with a focus on anxiety, depression, bipolar disorder and suicidal behavior. The selected interventions were assessed for their cost-effectiveness, affordability – comparing their annual cost per adolescent with NHS England per capita spending, and their implementation readiness.

Preventing anxiety and depression emerged as the most affordable and 'implementation ready' intervention, providing substantial health and economic benefits. The research also emphasized that universal school-based prevention interventions (delivered to whole age groups) were among the most affordable interventions.  A priority package, comprising anxiety and depression prevention, along with mild anxiety and mild depression treatment, could avert millions of Disability-Adjusted Life Years and achieve significant ROIs over both timeframes.

Funding for this work was provided through a charitable grant made by AstraZeneca's Young Health Programme

Read the full paper

Learn more about RTI’s center for global noncommunicable diseases