Peer-reviewed article
The economic case for increased investment in the treatment of adolescents with common mental disorders in Colombia and South Africa.
Sweeny K, Reavley N, Rasmussen B, Nenzhelele HQ, De Jong R et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examines the economic case for treating depression and anxiety in adolescents in Colombia and South Africa. Using economic modelling, the authors estimate that scaling up mental health interventions would generate significant financial returns—a benefit-cost ratio of 13.9 to 15.4 in Colombia and 13.0 to 13.9 in South Africa. The research shows that despite mental disorders affecting a large proportion of adolescents, treatment rates remain very low in these middle-income countries. The findings demonstrate that mental health interventions are cost-effective investments that could improve educational outcomes, productivity and social participation.
Key points
- Mental disorders account for 16–21% of adolescent disease burden depending on country income level
- Fewer than one in ten affected adolescents receive care in some low- and middle-income settings
- Scaling-up depression and anxiety treatment in Colombia produces a benefit-cost ratio of 13.9 to 15.4
- South Africa shows a benefit-cost ratio of 13.0 to 13.9 for the same intervention scale-up
- Poor adolescent mental health is linked to long-term losses in education, work productivity and social participation
Limitations
The study uses economic modelling rather than real-world implementation data, so actual costs and benefits may differ from projections. The document does not detail which specific interventions were modelled or provide information on implementation feasibility and barriers in these countries.
Abstract
Adolescence is a critical period for the emergence of mental health disorders. The prevalence of depression and anxiety among adolescents in high- and middle-income countries has increased over the past three decades. According to the Global Burden of Disease Study (2025), mental disorders account for 21.4% of the adolescent burden of disease in high socio-demographic index (SDI) countries and 16.1% and 18.6% in the middle- and low-SDI countries. Despite the high and rising burden, adolescent mental health remains less prioritized in policy and funding. Treatment rates in low- and middle-income countries are low, with fewer than one in ten affected adolescents receiving care in some settings. Poor mental health in adolescence is associated with long-term losses in educational attainment, productivity and social participation. There is growing evidence suggesting that mental health interventions for depression and anxiety can be cost-effective even in resource constrained settings. This paper presents new evidence on the return on investment from scaling up interventions for adolescent depression and anxiety in two middle-income countries: Colombia and South Africa. Using the OneHealth tool and an economic model previously applied in global adolescent investment cases, we estimate health, education and economic benefits under a scale-up scenario. Scaling-up treatment for depression and anxiety in Colombia results in a benefit-cost ratio (BCR) for economic benefits alone of 13.9 and for combined economic and social benefits of 15.4. For South Africa the BCRs are 13.0 and 13.9, respectively. Our findings offer policy-relevant evidence to support increased investment in adolescent mental health in settings where data and resources remain limited.