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

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  • 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
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    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.
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    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.

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    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

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