IDEAS home Printed from https://ideas.repec.org/p/iza/izadps/dp16839.html
   My bibliography  Save this paper

Talking Therapy: Impacts of a Nationwide Mental Health Service in England

Author

Listed:
  • Krekel, Christian

    (London School of Economics)

  • Srisuma, Sorawoot

    (University of Surrey)

Abstract

Common mental health problems impose significant costs on individuals and societies, yet healthcare systems often overlook them. We provide the first causal evidence on the effectiveness of a pioneering, nationwide mental health service for treating depression and anxiety disorders in England using non-experimental data and methods. We exploit variations in waiting times to identify treatment effects, based on a novel dataset of over one million patients that well represent the English population. Our findings show that treatment improved mental health and reduced impairment in work and social life. We also provide suggestive evidence of enhanced employment. However, effects vary across patients, services, and areas. The programme is cost-effective and provides a blueprint for treating mental health in other countries.

Suggested Citation

  • Krekel, Christian & Srisuma, Sorawoot, 2024. "Talking Therapy: Impacts of a Nationwide Mental Health Service in England," IZA Discussion Papers 16839, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp16839
    as

    Download full text from publisher

    File URL: https://docs.iza.org/dp16839.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Victor Chernozhukov & Denis Chetverikov & Mert Demirer & Esther Duflo & Christian Hansen & Whitney Newey & James Robins, 2018. "Double/debiased machine learning for treatment and structural parameters," Econometrics Journal, Royal Economic Society, vol. 21(1), pages 1-68, February.
    2. Christopher Blattman & Julian C. Jamison & Margaret Sheridan, 2017. "Reducing Crime and Violence: Experimental Evidence from Cognitive Behavioral Therapy in Liberia," American Economic Review, American Economic Association, vol. 107(4), pages 1165-1206, April.
    3. Jens Ludwig & Greg J. Duncan & Lisa A. Gennetian & Lawrence F. Katz & Ronald C. Kessler & Jeffrey R. Kling & Lisa Sanbonmatsu, 2013. "Long-Term Neighborhood Effects on Low-Income Families: Evidence from Moving to Opportunity," American Economic Review, American Economic Association, vol. 103(3), pages 226-231, May.
    4. Sevim, Dilek & Baranov, Victoria & Bhalotra, Sonia R. & Maselko, Joanna & Biroli, Pietro, 2023. "Socioemotional Skills in Early Childhood: Evidence from a Maternal Psychosocial Intervention," IZA Discussion Papers 15925, Institute of Labor Economics (IZA).
    5. Kamila Cygan‐Rehm & Daniel Kuehnle & Michael Oberfichtner, 2017. "Bounding the causal effect of unemployment on mental health: Nonparametric evidence from four countries," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1844-1861, December.
    6. Stefan Wager & Susan Athey, 2018. "Estimation and Inference of Heterogeneous Treatment Effects using Random Forests," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 113(523), pages 1228-1242, July.
    7. Emily A. Beam & Stella Quimbo, 2023. "The Impact of Short-Term Employment for Low-Income Youth: Experimental Evidence from the Philippines," The Review of Economics and Statistics, MIT Press, vol. 105(6), pages 1379-1393, November.
    8. Berger, Mark C & Black, Dan A, 1992. "Child Care Subsidies, Quality of Care, and the Labor Supply of Low-Income, Single Mothers," The Review of Economics and Statistics, MIT Press, vol. 74(4), pages 635-642, November.
    9. Frijters, Paul & Clark, Andrew E. & Krekel, Christian & Layard, Richard, 2020. "A happy choice: wellbeing as the goal of government," Behavioural Public Policy, Cambridge University Press, vol. 4(2), pages 126-165, July.
    10. Stillman, Steven & McKenzie, David & Gibson, John, 2009. "Migration and mental health: Evidence from a natural experiment," Journal of Health Economics, Elsevier, vol. 28(3), pages 677-687, May.
    11. Jane Cooley Fruehwirth & Sriya Iyer & Anwen Zhang, 2019. "Religion and Depression in Adolescence," Journal of Political Economy, University of Chicago Press, vol. 127(3), pages 1178-1209.
    12. Laura Dague & Thomas DeLeire & Lindsey Leininger, 2017. "The Effect of Public Insurance Coverage for Childless Adults on Labor Supply," American Economic Journal: Economic Policy, American Economic Association, vol. 9(2), pages 124-154, May.
    13. Matthew Lang, 2013. "The Impact Of Mental Health Insurance Laws On State Suicide Rates," Health Economics, John Wiley & Sons, Ltd., vol. 22(1), pages 73-88, January.
    14. Jason M. Fletcher, 2010. "Adolescent depression and educational attainment: results using sibling fixed effects," Health Economics, John Wiley & Sons, Ltd., vol. 19(7), pages 855-871, July.
    15. Achyuta Adhvaryu & James Fenske & Anant Nyshadham, 2019. "Early Life Circumstance and Adult Mental Health," Journal of Political Economy, University of Chicago Press, vol. 127(4), pages 1516-1549.
    16. Paul Frijters & David W. Johnston & Michael A. Shields, 2014. "The Effect Of Mental Health On Employment: Evidence From Australian Panel Data," Health Economics, John Wiley & Sons, Ltd., vol. 23(9), pages 1058-1071, September.
    17. Roland G. Fryer & Lawrence F. Katz, 2013. "Achieving Escape Velocity: Neighborhood and School Interventions to Reduce Persistent Inequality," American Economic Review, American Economic Association, vol. 103(3), pages 232-237, May.
    18. Sara B. Heller & Anuj K. Shah & Jonathan Guryan & Jens Ludwig & Sendhil Mullainathan & Harold A. Pollack, 2017. "Thinking, Fast and Slow? Some Field Experiments to Reduce Crime and Dropout in Chicago," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 132(1), pages 1-54.
    19. Barnay, Thomas & Juin, Sandrine, 2016. "Does home care for dependent elderly people improve their mental health?," Journal of Health Economics, Elsevier, vol. 45(C), pages 149-160.
    20. Sayantan Ghosal & Smarajit Jana & Anandi Mani & Sandip Mitra & Sanchari Roy, 2022. "Sex Workers, Stigma, and Self-Image: Evidence from Kolkata Brothels," The Review of Economics and Statistics, MIT Press, vol. 104(3), pages 431-448, May.
    21. Guido W. Imbens & Jeffrey M. Wooldridge, 2009. "Recent Developments in the Econometrics of Program Evaluation," Journal of Economic Literature, American Economic Association, vol. 47(1), pages 5-86, March.
    22. Brian A. Jacob & Jens Ludwig, 2012. "The Effects of Housing Assistance on Labor Supply: Evidence from a Voucher Lottery," American Economic Review, American Economic Association, vol. 102(1), pages 272-304, February.
    23. Thomas Bossuroy & Markus Goldstein & Bassirou Karimou & Dean Karlan & Harounan Kazianga & William Parienté & Patrick Premand & Catherine C. Thomas & Christopher Udry & Julia Vaillant & Kelsey A. Wrigh, 2022. "Tackling psychosocial and capital constraints to alleviate poverty," Nature, Nature, vol. 605(7909), pages 291-297, May.
    24. Robles, Silvia & Gross, Max & Fairlie, Robert W., 2021. "The effect of course shutouts on community college students: Evidence from waitlist cutoffs," Journal of Public Economics, Elsevier, vol. 199(C).
    25. Chatterji, Pinka & Alegria, Margarita & Takeuchi, David, 2011. "Psychiatric disorders and labor market outcomes: Evidence from the National Comorbidity Survey-Replication," Journal of Health Economics, Elsevier, vol. 30(5), pages 858-868.
    26. Gruber, Jonathan & Lordan, Grace & Pilling, Stephen & Propper, Carol & Saunders, Rob, 2022. "The impact of mental health support for the chronically ill on hospital utilisation: Evidence from the UK," Social Science & Medicine, Elsevier, vol. 294(C).
    27. Sevim, Dilek & Baranov, Victoria & Bhalotra, Sonia & Maselko, Joanna & Biroli, Pietro, 2023. "Trajectories of Early Childhood Skill Development and Maternal Mental Health," The Warwick Economics Research Paper Series (TWERPS) 1469, University of Warwick, Department of Economics.
    28. Nancy Reichman & Hope Corman & Kelly Noonan, 2015. "Effects of maternal depression on couple relationship status," Review of Economics of the Household, Springer, vol. 13(4), pages 929-973, December.
    29. Amy Finkelstein & Nathaniel Hendren & Erzo F. P. Luttmer, 2019. "The Value of Medicaid: Interpreting Results from the Oregon Health Insurance Experiment," Journal of Political Economy, University of Chicago Press, vol. 127(6), pages 2836-2874.
    30. Brian A. Jacob & Max Kapustin & Jens Ludwig, 2015. "The Impact of Housing Assistance on Child Outcomes: Evidence from a Randomized Housing Lottery," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(1), pages 465-506.
    31. Richard Layard, 2016. "The economics of mental health," IZA World of Labor, Institute of Labor Economics (IZA), pages 321-321, December.
    32. Chuard, Caroline, 2023. "Negative effects of long parental leave on maternal health: Evidence from a substantial policy change in Austria," Journal of Health Economics, Elsevier, vol. 88(C).
    33. Sevim, Dilek & Baranov, Victoria & Bhalotra, Sonia & Maselko, Joanna & Biroli, Pietro, 2023. "Trajectories of Early Childhood Skill Development and Maternal Mental Health," CAGE Online Working Paper Series 674, Competitive Advantage in the Global Economy (CAGE).
    34. Roth, Jonathan & Sant’Anna, Pedro H.C. & Bilinski, Alyssa & Poe, John, 2023. "What’s trending in difference-in-differences? A synthesis of the recent econometrics literature," Journal of Econometrics, Elsevier, vol. 235(2), pages 2218-2244.
    35. Fletcher Jason, 2009. "All in the Family: Mental Health Spillover Effects between Working Spouses," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 9(1), pages 1-21, February.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Emma Sharland & Marta Rossa & Ted Dolby & Ekaterina Oparina & Rob Saunders & Daniel Ayoubkhani & Vahe Nifilyan & Klaudia Rzepnicka, 2025. "The effect of adult psychological therapies on employment and earnings: Evidence from England," CEP Discussion Papers dp2070, Centre for Economic Performance, LSE.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Arbour, William & Lacroix, Guy & Marchand, Steeve, 2021. "Prison Rehabilitation Programs: Efficiency and Targeting," IZA Discussion Papers 14022, Institute of Labor Economics (IZA).
    2. Cassidy, Michael T., 2020. "A Closer Look: Proximity Boosts Homeless Student Performance in New York City," IZA Discussion Papers 13558, Institute of Labor Economics (IZA).
    3. Palmer, Caroline & Phillips, David C. & Sullivan, James X., 2019. "Does emergency financial assistance reduce crime?," Journal of Public Economics, Elsevier, vol. 169(C), pages 34-51.
    4. Michael C. Knaus, 2021. "A double machine learning approach to estimate the effects of musical practice on student’s skills," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 184(1), pages 282-300, January.
    5. Mark Kattenberg & Bas Scheer & Jurre Thiel, 2023. "Causal forests with fixed effects for treatment effect heterogeneity in difference-in-differences," CPB Discussion Paper 452, CPB Netherlands Bureau for Economic Policy Analysis.
    6. Guido W. Imbens, 2020. "Potential Outcome and Directed Acyclic Graph Approaches to Causality: Relevance for Empirical Practice in Economics," Journal of Economic Literature, American Economic Association, vol. 58(4), pages 1129-1179, December.
    7. Anett John & Kate Orkin, 2022. "Can Simple Psychological Interventions Increase Preventive Health Investment?," Journal of the European Economic Association, European Economic Association, vol. 20(3), pages 1001-1047.
    8. Andre Luis Squarize Chagas & Guilherme Malvezzi Rocha, 2019. "Housing program and social conditions impact: Evidences from Minha Casa Minha Vida program lotteries in Brazil," Working Papers, Department of Economics 2019_40, University of São Paulo (FEA-USP), revised 05 Nov 2019.
    9. Fredrik Andersson & John C. Haltiwanger & Mark J. Kutzbach & Giordano Palloni & Henry O. Pollakowski & Daniel H. Weinberg, 2013. "Childhood Housing and Adult Earnings: A Between-Siblings Analysis of Housing Vouchers and Public Housing," Working Papers 13-48, Center for Economic Studies, U.S. Census Bureau.
    10. Anna Baiardi & Andrea A. Naghi, 2021. "The Value Added of Machine Learning to Causal Inference: Evidence from Revisited Studies," Papers 2101.00878, arXiv.org.
    11. Michael C Knaus & Michael Lechner & Anthony Strittmatter, 2021. "Machine learning estimation of heterogeneous causal effects: Empirical Monte Carlo evidence," The Econometrics Journal, Royal Economic Society, vol. 24(1), pages 134-161.
    12. Daniel Goller & Tamara Harrer & Michael Lechner & Joachim Wolff, 2021. "Active labour market policies for the long-term unemployed: New evidence from causal machine learning," Papers 2106.10141, arXiv.org, revised May 2023.
    13. repec:osf:socarx:b4fc7_v1 is not listed on IDEAS
    14. Brett R. Gordon & Robert Moakler & Florian Zettelmeyer, 2022. "Close Enough? A Large-Scale Exploration of Non-Experimental Approaches to Advertising Measurement," Papers 2201.07055, arXiv.org, revised Oct 2022.
    15. Joshua B. Gilbert & Zachary Himmelsbach & James Soland & Mridul Joshi & Benjamin W. Domingue, 2024. "Estimating Heterogeneous Treatment Effects with Item-Level Outcome Data: Insights from Item Response Theory," Papers 2405.00161, arXiv.org, revised Jan 2025.
    16. Max H. Farrell & Tengyuan Liang & Sanjog Misra, 2021. "Deep Neural Networks for Estimation and Inference," Econometrica, Econometric Society, vol. 89(1), pages 181-213, January.
    17. Raj Chetty & Nathaniel Hendren & Lawrence F. Katz, 2016. "The Effects of Exposure to Better Neighborhoods on Children: New Evidence from the Moving to Opportunity Experiment," American Economic Review, American Economic Association, vol. 106(4), pages 855-902, April.
    18. Deza, Monica & Maclean, Johanna Catherine & Solomon, Keisha, 2022. "Local access to mental healthcare and crime," Journal of Urban Economics, Elsevier, vol. 129(C).
    19. Anthony Strittmatter, 2018. "What Is the Value Added by Using Causal Machine Learning Methods in a Welfare Experiment Evaluation?," Papers 1812.06533, arXiv.org, revised Dec 2021.
    20. Victoria Baranov & Sonia Bhalotra & Pietro Biroli & Joanna Maselko, 2017. "Maternal Depression, Women’s Empowerment, and Parental Investment: Evidence from a Large Randomized Control Trial," CHILD Working Papers Series 60 JEL Classification: I1, Centre for Household, Income, Labour and Demographic Economics (CHILD) - CCA.
    21. Wolfgang Stojetz & Tilman Brück, 2023. "Exposure to collective gender-based violence causes intimate partner violence," HiCN Working Papers 389, Households in Conflict Network.

    More about this item

    Keywords

    policy evaluation; mental health; psychological therapies; quasi- natural experiment; machine learning; cost-benefit analysis;
    All these keywords.

    JEL classification:

    • C31 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models; Quantile Regressions; Social Interaction Models
    • C32 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Time-Series Models; Dynamic Quantile Regressions; Dynamic Treatment Effect Models; Diffusion Processes; State Space Models
    • D61 - Microeconomics - - Welfare Economics - - - Allocative Efficiency; Cost-Benefit Analysis
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:iza:izadps:dp16839. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Holger Hinte (email available below). General contact details of provider: https://edirc.repec.org/data/izaaade.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.