Roberts, G., & Grimes, K. (2011). Return on Investment—Mental Health Promotion and Mental Illness Prevention.Canadian Policy Network at the University of Western Ontario. target=”_blank”>https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC1658.

“The present study, funded by CPHI (Canadian Health Population Initiative), reviews the body of evidence associated with the return on investment (ROI)i of mental health promotion and mental illness prevention.ii The specific research question being addressed is as follows:
‘What are the extent, range and nature of research activity in the area of economic analysis of mental health promotion and mental illness prevention?'”

“Both peer-reviewed (2001 to 2011) and grey literature sources were explored.The review shows that several systematic reviews and/or meta-analyses make the case for investing in mental health promotion and mental illness prevention, although the number of randomized controlled trials in each area is low. This report shows evidence of this finding for the health, education and workplace sectors and, to a lesser extent, the criminal justice and social services sectors, recognizing that there are considerable overlaps among these categories and studies.”

“Five themes emerged from the research:

• Existing evidence: The current research evidence is suggestive of ROI for some interventions. There are a number of high-quality systematic reviews and meta-analyses, although the number of randomized trials in each area was low and there is an overall lack of evidence for Canada. More evidence appears for illness prevention activities, and most studies were found at the individual/organizational level. Due to the difficulties associated with economic analysis, it was challenging to make clear comparisons across studies and samples. The weakest evidence for ROI in mental health promotion/illness prevention came from the workplace or private sector
  due to a general lack of high-quality research studies.
• Areas with potential: The strongest evidence for ROI is for children and adolescents in terms of reducing conduct disorders and depression, parenting and anti-bullying/-stigma programs, suicide awareness and prevention, health promotion in schools and primary health care screening for depression and alcohol misuse.
• Definitions and data measurement challenges: There is a lack of standard definitions in the areas of mental health, mental health promotion/illness prevention and ROI/economic analysis. A common lexicon that crosses sectors (health, education, criminal justice, social services and workplace) is vital when working in the area of mental health promotion/illness prevention. As well, data and measurement issues are not easily resolved. No expenditure information on investments in mental health promotion/mental illness prevention in Canada could be uncovered at this time, and the data on mental health expenditures is research-based. Data that crosses sectors is often difficult to integrate and compare.
• “Mental health–in-all-policies” approach: The review demonstrates that one of the unique challenges with ROI studies in mental health promotion/illness prevention is that, to a large extent, the returns (economic or otherwise) typically show up in a sector other than the one in which the initial investments are made. Until policies/incentives and accounting/data systems are developed and then linked horizontally across sectors, progress in the area of mental health promotion/illness prevention will depend on
  the goodwill of sectors to cooperate and communicate. Policy development might be improved through a “mental health–in-all-policies” approach that consistently and systematically crosses sectors, similar to that being implemented in the U.K.
• Sustainability: If the estimates in Ireland and Wales hold true in Canada, the current cost of mental illness is approximately $192 billion—the amount spent on the entire health care system in Canada.7 Current cost estimates for mental illness in Canada lack a full-cost accounting approach and are likely understated. There is mounting evidence that the growing cost to society of mental illness is not sustainable. One solution lies in promoting mental health and preventing mental illness.”