Presentation (CTI)

OBJECTIVES: Depression is among the most prevalent mental health conditions in the UK and can lead to economic inactivity and a need for welfare, with significant implications for public spending. Preventative programmes may significantly reduce the risk and symptom severity of depression. Preventing incident cases of depression may have considerable fiscal value in reduced exits from the workforce and need for associated welfare. Here we quantify the total fiscal burden of depression in England, and estimate potential fiscal savings associated with its prevention.
METHODS: We estimated the total fiscal impact of depression using StatXplore, focusing on PIP (Personal Independence Payment), UC (Universal Credit) and ESA (Employment Support Allowance). We used prevalence ratios to estimate claims due to depression. Claimant populations were projected from 2025-2030, in line with published DWP projections. Annual unit costs were calculated for depression-related PIP, UC and ESA claims, and applied to current and projected populations. We estimated potential fiscal savings through interventions to prevent depression. Treatment effects from the literature were applied to annual incident depression-related welfare claims.
RESULTS: Whilst the depression-related welfare population for UC/PIP is estimated to increase from 226,379 to 332,458 by 2030, the ESA population is expected to decrease from 313,939 to 193,795 as it becomes a legacy benefit. Total current fiscal cost is estimated at £4.1 billion annually, reaching £4.2 billion in 2030. If new cases of depression requiring welfare can be reduced by 19%, the overall population dependent on welfare could be reduced by 14% by 2030, translating to fiscal savings of £2.6 billion over 5 years. Per person prevented, this is equivalent to the cost of over 68 full courses of a CBT-based prevention programme.
CONCLUSIONS: Prevention of depression is underfunded despite having value beyond the healthcare system. This analysis shows that preventive interventions may offer significant fiscal value.