The health and economic benefits of youth mental health system reform: exploring the optimal mix of interventions and service capacity through simulation modelling

Value Health. 2026 Feb 13:S1098-3015(26)00052-5. doi: 10.1016/j.jval.2026.01.022. Online ahead of print.

ABSTRACT

OBJECTIVES: To help address the youth mental health crisis affecting many countries, there is an opportunity for planners to use formalised priority-setting frameworks and sophisticated modelling tools to guide their investment decisions. The objective of this study was to explore how different types of system constraints affected the optimal configuration of existing services and new interventions, and to estimate the downstream health and cost consequences for each of the scenarios.

METHODS: Constrained optimisation analysis was used within a system dynamics modelling (SDM) framework to systematically test the cost effectiveness of seven scenarios varying existing mental health services capacity growth, new interventions targeted at youths, and budget constraints on the amount of investment funds available for new interventions. Incremental net monetary benefit (INMB) was the outcome selected to be optimised. Both health care and societal perspectives were adopted, and costs were in 2020-21 Australian dollars.

RESULTS: Allowing existing services to expand beyond their long-run average growth rates and implementing five of the interventions resulted in the following outcomes accumulated over 11 years compared with business as usual: 16,139 QALYs gained, 294 (13%) suicide deaths avoided, 41,663 (30%) mental-health related emergency department presentations avoided, and 5,869 (17%) self-harm hospitalisations avoided. Combined with an investment of AUD$36.6 million in new interventions, total cost savings (societal perspective) were AUD$731.3 million, and INMB (i.e. overall economic value; societal perspective) was AUD$2.07 billion.

CONCLUSIONS: The estimates of overall economic value provide a rationale and support for greater investments in mental health and guidance for the implementation of regional mental health system reform.

PMID:41692383 | DOI:10.1016/j.jval.2026.01.022