Quality Assessment of Economic Evaluations of Suicide and Self-Harm Interventions
A Systematic Review
Abstract
Abstract.Background: Death following self-harm constitutes a major global public health challenge and there is an urgent need for governments to implement cost-effective, national suicide prevention strategies. Aim: To conduct a systematic review and quality appraisal of the economic evaluations of interventions aimed at preventing suicidal behavior. Method: A systematic literature search was performed in several literature databases to identify relevant articles published from 2003 to 2016. Drummond's 10-item appraisal tool was used to assess the methodological quality of the included studies. Results: In total, 25 documents encompassing 30 economic evaluations were included in the review. Of the identified evaluations, 10 studies were found to be of poor quality, 14 were of average quality, and six studies were considered of good quality. The majority of evaluations found the interventions to be cost-effective. Limitations: Several limitations were identified and discussed in the article. Conclusion: A notable few economic evaluations were identified. The studies were diverse, primarily set in high-income countries, and often based on modeling, emphasizing the need for more primary research into the topic. The discussion of suicide and self-harm prevention should be as nuanced as possible, including health economics along with cultural, social, and political aspects.
References
2004). The costs, effects and cost-effectiveness of strategies to increase coverage of routine immunizations in low- and middle-income countries: Systematic review of the grey literature. Bulletin of the World Health Organization, 82(9), 689–696.
(2007). Risk factors for suicidality in Europe: Results from the ESEMED study. Journal of Affective Disorders, 101(1–3), 27–34.
(2013). Joint crisis plans for people with borderline personality disorder: Feasibility and outcomes in a randomised controlled trial. British Journal of Psychiatry, 202(5), 357–364.
(2003). Cost-effectiveness of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate self-harm: a decision-making approach. Psychological Medicine, 33(6), 977–986.
(2013). Cost effectiveness of a community-based crisis intervention program for people bereaved by suicide. Crisis, 34(6), 390–397.
(2015). Training mental health professionals in suicide practice guideline adherence: Cost-effectiveness analysis alongside a randomized controlled trial. Journal of Affective Disorders, 186, 203–210.
(2015). Economic evaluations of Internet interventions for mental health: a systematic review. Psychological Medicine, 45(16), 3357–3376.
(2016). The impact of a suicide prevention strategy on reducing the economic cost of suicide in the New South Wales construction industry. Crisis, 37(2), 121–129.
(2005). Methods for the economic evaluation of health care programmes. New York. NY: Oxford University Press.
(2003). Modelling the impact of clozapine on suicide in patients with treatment-resistant schizophrenia in the UK. British Journal of Psychiatry, 182, 505–508.
(2003). Deaths due to absence of an affordable antitoxin for plant poisoning. Lancet, 362(9389), 1041–1044.
(2014). Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet, 385(9963), 117–171.
. (1996). Cost-effectiveness in health and medicine. New York, NY: Oxford University Press.
(2011). Best practices: The Utah Youth Suicide Study: Best practices for suicide prevention through the juvenile court system. Psychiatric Services, 62(12), 1416–1418.
(2011). Group therapy for adolescents with repeated self harm: randomised controlled trial with economic evaluation. BMJ, 342, d682.
(2004). For which strategies of suicide prevention is there evidence of effectiveness. Copenhagen, Denmark: WHO Regional Office for Europe.
(2012). Self-harm and suicide in adolescents. Lancet, 379(9834), 2373–2382.
(2016). World economic outlook database. Retrieved from https://www.imf.org/external/pubs/ft/weo/2016/02/weodata/index.aspx
. (2015). Economic effects of legislations and policies to expand mental health and substance abuse benefits in health insurance plans: A community guide systematic review. Journal of Mental Health Policy and Economics, 18(1), 39–48.
(2004). Managing suicides via videoconferencing in a remote northern community in Canada. International Journal of Circumpolar Health, 63(4), 422–428.
(2011). Mental health promotion and mental illness prevention: The economic case. London, UK: Department of Health.
(2015). Quality assessment of economic evaluations of health promotion programs for children and adolescents – a systematic review using the example of physical activity. Health Economics Review, 5(1), 35.
(2014). Cost-effectiveness of a rapid response team intervention for suicidal youth presenting at an emergency department. Canadian Journal of Psychiatry, 59(6), 310–318.
(2011). An economic evaluation of setting up physical barriers in railway stations for preventing railway injury: Evidence from Hong Kong. Journal of Epidemiology and Community Health, 65(10), 915–920.
(2005). Suicide prevention strategies: a systematic review. JAMA, 294(16), 2064–74.
(2011). The economic analysis of prevention in mental health programs. Annual Review of Clinical Psychology, 7, 169–201.
(2012). Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380(9859), 2197–2223.
(2014). Social return on investment forecast of the Lifeline Online Crisis Support Chat Service. Deakin, Australia: Lifeline.
. (2016). Early intervention for first-episode psychosis: Broadening the scope of economic estimates. Early Intervention in Psychiatry, 10(2), 144–151.
(2013). Cost-effectiveness of a helpline for suicide prevention. Journal of Telemedicine and Telecare, 19(5), 273–281.
(2006). Evaluation of the first phase of Choose Life: The national strategy and action plan to prevent suicide in Scotland. Edinburgh, UK: Scottish Executive.
(2012). Effectiveness and cost-effectiveness of dialectical behaviour therapy for self-harming patients with personality disorder: A pragmatic randomised controlled trial. Psychotherapy and Psychosomatics, 81(6), 356–365.
(2014). The return on investment of postdischarge follow-up calls for suicidal ideation or deliberate self-harm. Psychiatric Services, 65(8), 1012–1019.
(2008). Should we invest in suicide prevention programs? Journal of Socio-Economics, 37(1), 262–275.
(2015). Clinical trials provide essential evidence, but rarely offer a vehicle for cost-effectiveness analysis. Value in Health, 18(2), 141–142.
(2012). A cost effectiveness analysis of the preferred antidotes for acute paracetamol poisoning patients in Sri Lanka. BMC Clinical Pharmacology, 12, 6.
(2011). Post-suicide intervention programs: A systematic review. Canadian Journal of Public Health, 102(1), 18–29.
(2016). Databases, tables & calculators by subject. Retrieved from http://www.bls.gov/data/inflation_calculator.htm
. (2012). Reducing suicidal ideation: Cost-effectiveness analysis of a randomized controlled trial of unguided web-based self-help. Journal of Medical Internet Research, 5, 329–342.
(1998). Suicide-preventive effects of perestroika in the former USSR: The role of alcohol restriction. Acta Psychiatrica Scandinavica, 98(394), 1–4.
(2013). Analysis of the cost effectiveness of a suicide barrier on the Golden Gate Bridge. Crisis, 34(2), 98–106.
(2012). Public health action for the prevention of suicide: a framework. Geneva, Switzerland: Author.
. (2014). Preventing suicide. A global imperative. Geneva, Switzerland: Author.
. (2003). Reducing injuries among Native Americans: Five cost-outcome analyses. Accident; Analysis and Prevention, 35(5), 631–639.
(2008). Is it worth investing in mental health promotion and prevention of mental illness? A systematic review of the evidence from economic evaluations. BMC Public Health, 8, 20.
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