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Economic Evaluation of Mental Health Interventions for Children and Adolescents: the Case of Sweden
Örebro University, Orebro University School of Business, Örebro University, Sweden.ORCID iD: 0000-0001-6108-8227
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The focus of this thesis is economic evaluations of programs and interventions regarding children and adolescents with mental health issues, victimization, and intellectual disabilities (ID). The first paper examines a potential link between mental health issues among adolescent and the class-size of the school class they are enrolled in. The class-size and schools’ financial resources is often at the center of policy debates. Our results suggest that there is no evidence that larger classes have negative impact on the mental health for adolescents in a Swedish context. The second paper investigate the societal willingness to pay (WTP) to reduce bullying in Swedish schools. The results suggest that the tax payers WTP is about 5 SEK and the societal is about 600 000 SEK per reduced bullying victim. This value of WTP could be used as a measure to evaluate different investments in anti-bullying programs and efforts to reduce the bullying in schools. The third paper estimates the cost-effectiveness of one recently introduced antibullying program, the Finnish KiVa program, one of the few evidence based programs in the world. Based on a decision-analytic model, the results indicate that the KiVa program is a cost-effective program that has a cost per reduced victim well below the WTP as estimated in the second paper as documented above. The fourth paper evaluates, from the municipality perspective, the effects of investing in a SE program compared to “business as usual” in order to increase the likelihood for gaining regular employment for the pupils with ID. The results indicate that it takes 9 years before breakeven is reached if investing in the SE program. The fifth paper conducts a decision-analytic economic evaluation of the SE program using simulations to assess the effects over the full life-course. The results suggest that from a societal perspective the program is cost-effective ten years after the investment and by then has generated a benefit of 17 000 SEK per individual.

Place, publisher, year, edition, pages
Örebro: Örebro university , 2016. , 28 p.
Series
Örebro Studies in Economics, ISSN 1651-8896 ; 35
Keyword [en]
Children, adolescents, mental health, bullying, economic evaluation, intellectual disability, transition
National Category
Economics
Research subject
Economics
Identifiers
URN: urn:nbn:se:oru:diva-52881ISBN: 978-91-7529-169-7OAI: oai:DiVA.org:oru-52881DiVA: diva2:1033830
Public defence
2016-12-09, Örebro universitet, Prismahuset, Hörsal 201, Fakultetsgatan 1, Örebro, 10:15 (Swedish)
Opponent
Supervisors
Available from: 2016-10-10 Created: 2016-10-10 Last updated: 2016-11-18Bibliographically approved
List of papers
1. Class-size effects on adolescents' mental health and well-being in Swedish schools
Open this publication in new window or tab >>Class-size effects on adolescents' mental health and well-being in Swedish schools
2013 (English)In: Education Economics, ISSN 0964-5292, E-ISSN 1469-5782, Vol. 21, no 3, 248-263 p.Article in journal (Refereed) Published
Abstract [en]

This paper analyzes whether class size has an effect on the prevalence of mental health problems and well-being among adolescents in Swedish schools. We use cross-sectional data collected in year 2008 covering 2755 Swedish adolescents in ninth grade from 40 schools and 159 classes. We utilize different econometric approaches to address potential between- and within-school endogeneity including school-fixed effects and regression discontinuity approaches. Our results indicate no robust effects of class size on the prevalence of mental health problems and well-being, and we cannot reject the hypothesis that class size has no effect on mental health and well-being at all.

Place, publisher, year, edition, pages
Routledge, 2013
National Category
Economics
Research subject
Economics
Identifiers
urn:nbn:se:oru:diva-34226 (URN)10.1080/09645292.2013.789826 (DOI)2-s2.0-84878983311 (ScopusID)
Available from: 2014-03-12 Created: 2014-03-12 Last updated: 2016-11-18Bibliographically approved
2. The willingness to pay to reduce school bullying
Open this publication in new window or tab >>The willingness to pay to reduce school bullying
2013 (English)In: Economics of Education Review, ISSN 0272-7757, E-ISSN 1873-7382, Vol. 35, 1-11 p.Article in journal (Refereed) Published
Abstract [en]

The number of programs used to reduce bullying in schools is increasing, but often with a lack of understanding of the effectiveness and monetary benefits. This paper uses a discrete choice experiment conducted in Sweden in the spring of 2010 to elicit the willingness to pay (WTP) to reduce school bullying. Non-parametric and parametric approaches indicate a mean marginal WTP of 5.95-8.48 Swedish kronor ((sic)0.66-0.95) for each reduced victim of bullying. The aggregate societal WTP for each reduced statistical victim of bullying, referred to here as the value of a statistical bullying-victim (VSBV), is then 585,090-835,280 Swedish kronor ((sic)65,446-93,431). The VSBV may be interpreted as the aggregate WTP to prevent one statistical case of a bullying-victim. The result may be used to conduct economic evaluations of antibullying programs, which is demonstrated here by a simple cost-benefit analysis of one of the most common antibullying programs. The VSBV may also be relevant for providing policymakers with useful information on taxpayers' preferred allocations to antibullying programs in general.

Place, publisher, year, edition, pages
Elsevier, 2013
Keyword
Willingness to pay, Discrete choice experiment, Bullying, School, Cost-benefit analysis
National Category
Economics
Research subject
Economics
Identifiers
urn:nbn:se:oru:diva-30183 (URN)10.1016/j.econedurev.2013.02.004 (DOI)000321089000001 ()2-s2.0-84877344578 (ScopusID)
Available from: 2013-08-13 Created: 2013-08-13 Last updated: 2016-11-18Bibliographically approved
3. The Cost-Effectiveness of the KiVa Antibullying Program: Results from a Decision-Analytic Model
Open this publication in new window or tab >>The Cost-Effectiveness of the KiVa Antibullying Program: Results from a Decision-Analytic Model
(English)Manuscript (preprint) (Other academic)
National Category
Economics
Research subject
Economics
Identifiers
urn:nbn:se:oru:diva-53550 (URN)
Available from: 2016-11-18 Created: 2016-11-18 Last updated: 2016-11-18Bibliographically approved
4. Investing in Pupils with Intellectual Disabilities: A Quasi-Experimental Evaluation of a Supported Employment Inspired Program as a Means for Reducing Future Local Government Costs
Open this publication in new window or tab >>Investing in Pupils with Intellectual Disabilities: A Quasi-Experimental Evaluation of a Supported Employment Inspired Program as a Means for Reducing Future Local Government Costs
(English)Manuscript (preprint) (Other academic)
National Category
Economics
Research subject
Economics
Identifiers
urn:nbn:se:oru:diva-53551 (URN)
Available from: 2016-11-18 Created: 2016-11-18 Last updated: 2016-11-18Bibliographically approved
5. A Benfit-Cost Analysis of an Individual Placement and Support program for Adolescents with Intellectual Disabilities
Open this publication in new window or tab >>A Benfit-Cost Analysis of an Individual Placement and Support program for Adolescents with Intellectual Disabilities
(English)Manuscript (preprint) (Other academic)
National Category
Economics
Research subject
Economics
Identifiers
urn:nbn:se:oru:diva-53552 (URN)
Available from: 2016-11-18 Created: 2016-11-18 Last updated: 2016-11-18Bibliographically approved

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