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Cost-Effectiveness of a Universal School-Based Mental Health Prevention Program: An Economic Modeling Study in a
Ha T Nguyen1, Anh Q Nguyen2, Nga T Nguyen1
1Hanoi University of Public Health, Hanoi, Vietnam.
Applied Health Economics and Health Policy
|June 10, 2025
Summary
Investing in the Happy House (HH) school-based mental health program is cost-effective for preventing depression in Vietnam. Scaling up HH improves its economic value, offering significant benefits compared to no intervention.
Area of Science:
- Global Mental Health
- Health Economics
- Adolescent Psychology
Background:
- Adolescent depression poses a significant public health challenge, particularly in low- and middle-income countries.
- School-based mental health programs offer a scalable platform for early intervention and prevention.
- Limited evidence exists on the cost-effectiveness of such programs in resource-constrained settings.
Purpose of the Study:
- To evaluate the cost-effectiveness of the Happy House (HH) school-based mental health prevention program.
- To inform investment decisions for mental health interventions in limited-income contexts.
- To compare the economic value of HH against a do-nothing approach over various time horizons.
Main Methods:
- A culturally adapted, evidence-based resilience intervention (Happy House) was implemented in Vietnamese high schools.
- A Markov model assessed cost-effectiveness from a societal perspective, using data from a controlled trial and local cost information.
- Quality-adjusted life years (QALYs) were calculated using EQ-5D-5L survey data and systematic reviews, with a 3% discount rate.
Main Results:
- The Happy House program demonstrated cost-effectiveness, with incremental cost-effectiveness ratios (ICERs) ranging from 43.8 million VND to 22.9 million VND per QALY gained over 5-year to lifetime horizons.
- Nationwide scaling of HH significantly reduced ICERs, ranging from 27.6 million VND to 13.5 million VND per QALY.
- Sensitivity analyses confirmed the robustness of the findings regarding effect size, disease incidence, and intervention costs.
Conclusions:
- A universal school-based mental health program like Happy House is a cost-effective investment in limited-income settings.
- Scaling up HH implementation is crucial for maximizing cost-effectiveness, especially with rising rates of adolescent depression.
- These findings support increased investment in school-based mental health prevention programs in Vietnam and similar contexts.
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