Estimating the ‘Return-On-Investment' For California's Statewide Mental Health Prevention and Early Intervention Initiatives

Background: The California Mental Health Services Authority (CalMHSA) statewide prevention and early intervention (PEI) initiatives seek to reduce stigma and discrimination associated with mental health problems, prevent suicide, and improve student mental health. One measure of effectiveness is the economic return to the state from investments in these programs. This presentation will define Return-on-Investment in the context of statewide prevention and early intervention programs and summarize return on investment estimates for a suicide prevention initiative in California,

There are a number of challenges to estimating a return on investment for these types of programs, especially since many of the important outcomes are non-monetary (e.g. improved well-being or decreased suffering) and “returns” may take years to be measureable. While there is evidence of the effectiveness of these types of programs, there is very little evidence of their impact on economic outcomes.

Method: To illustrate the challenges of this type of analysis, we focused on completing an ROI Analysis for one program in the CalMHSA prevention portfolio: gate keeper training for suicide prevention. We develop a model linking components of the training program to short-term and long-term outcomes. We then used data collected through the evaluation of the program, demographic and income data for California, and estimates from literature on the effectiveness of similar programs to populate our model and estimate a return on investment.

Findings/Implications: We estimate that the impact of each year of investment in the training program would be a reduction of 3,600 suicide attempts and 140 deaths over the next 3 decades, a reduction of 0.13%. In addition, we estimate a positive financial return to the state in terms of reduced health care spending to treat suicide attempts; increased earnings from a reduction in deaths; and incapacitation from suicide attempts. We estimate a return of $51 to the state government for each $1 dollar invested in training. During the presentation we will discuss the process of performing Return-on-Investment analyses in detail.