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