Economic Evaluations of Preventive Interventions for Self-Harm and Suicide: A Systematic Review
Author(s)
Long Le, PhD;
Monash University, Dr, Melbourne, Australia
Monash University, Dr, Melbourne, Australia
OBJECTIVES: Background: Self-harm and suicide are major public health concerns that are consistently ranked among the top leading causes of mortality worldwide, highlighting a pressing need for policymakers to identify and implement cost-effective interventions. Objective: This systematic review aims to synthesize the available cost-effectiveness evidence for the prevention of self-harm and suicide.
METHODS: Method: Systematic searches were performed in MEDLINE, Embase, PsycINFO, CINAHL, and Econlit to identify full economic evaluations and return-on-investment studies on preventive interventions for self-harm and suicide, published up to 05 September 2023. Drummond's 10-point checklist was utilized to assess the methodological quality of the eligible studies. This review adhered to the PRISMA guidelines and summarized findings in a narrative synthesis (PROSPERO registration #CRD42023460339).
RESULTS: Results: A total of 55 eligible studies evaluated 15 types of interventions, including four universal, four selective, five indicated, and two multi-level. Most studies were conducted in high-income countries (n=49/55) and primarily assessed the cost-effectiveness of universal interventions like means restriction (n=5) and multi-components (n=5), as well as selective and indicated interventions such as psychotherapy (n=22), support services (n=12), and medication (n=4). Evidence supported the cost-effectiveness of several universal (e.g., awareness training, multi-component, guidelines and policy implementation), selective (e.g., psychotherapy, support services), indicated (e.g., suicide risk screening, support services, and psychotherapy for adults outside the UK), and multi-level interventions. The majority of studies (n=47/55) were rated high-quality.
CONCLUSIONS: Conclusions: Existing evidence consistently found that interventions for self-harm and suicide were cost-effective or cost-saving. More economic evaluations are needed for interventions targeting older adults and children in all countries, especially in low-middle-income countries, where economic evaluations are lacking
METHODS: Method: Systematic searches were performed in MEDLINE, Embase, PsycINFO, CINAHL, and Econlit to identify full economic evaluations and return-on-investment studies on preventive interventions for self-harm and suicide, published up to 05 September 2023. Drummond's 10-point checklist was utilized to assess the methodological quality of the eligible studies. This review adhered to the PRISMA guidelines and summarized findings in a narrative synthesis (PROSPERO registration #CRD42023460339).
RESULTS: Results: A total of 55 eligible studies evaluated 15 types of interventions, including four universal, four selective, five indicated, and two multi-level. Most studies were conducted in high-income countries (n=49/55) and primarily assessed the cost-effectiveness of universal interventions like means restriction (n=5) and multi-components (n=5), as well as selective and indicated interventions such as psychotherapy (n=22), support services (n=12), and medication (n=4). Evidence supported the cost-effectiveness of several universal (e.g., awareness training, multi-component, guidelines and policy implementation), selective (e.g., psychotherapy, support services), indicated (e.g., suicide risk screening, support services, and psychotherapy for adults outside the UK), and multi-level interventions. The majority of studies (n=47/55) were rated high-quality.
CONCLUSIONS: Conclusions: Existing evidence consistently found that interventions for self-harm and suicide were cost-effective or cost-saving. More economic evaluations are needed for interventions targeting older adults and children in all countries, especially in low-middle-income countries, where economic evaluations are lacking
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE485
Topic
Economic Evaluation
Disease
SDC: Injury & Trauma, SDC: Mental Health (including addition)