Citation

Ahern S, Burke LA, McElroy B, Corcoran P, McMahon EM, Keeley H, Carli V, Wasserman C, Hoven CW, Sarchiapone M, Apter A, Balazs J, Banzer R, Bobes J, Brunner R, Cosman D, Haring C, Kaess M, Kahn JP, Keresztény A, Postuvan V, Saiz PA, Värnik P, Wasserman D. Eur. Child Adolesc. Psychiatry 2018; 27(10): 1295-1304.

Affiliation

WHO Collaborating Centre for Training, Research and Methods Development in Suicide Prevention, Stockholm, Sweden.

Copyright

(Copyright © 2018, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00787-018-1120-5

PMID

29442231

Abstract

Suicide is one of the leading causes of death among young people globally. In light of emerging evidence supporting the effectiveness of school-based suicide prevention programmes, an analysis of cost-effectiveness is required. We aimed to conduct a full cost-effectiveness analysis (CEA) of the large pan-European school-based RCT, Saving and Empowering Young Lives in Europe (SEYLE). The health outcomes of interest were suicide attempt and severe suicidal ideation with suicide plans. Adopting a payer's perspective, three suicide prevention interventions were modelled with a Control over a 12-month time period. Incremental cost-effectiveness ratios (ICERs) indicate that the Youth Aware of Mental Health (YAM) programme has the lowest incremental cost per 1% point reduction in incident for both outcomes and per quality adjusted life year (QALY) gained versus the Control. The ICERs reported for YAM were €34.83 and €45.42 per 1% point reduction in incident suicide attempt and incident severe suicidal ideation, respectively, and a cost per QALY gained of €47,017 for suicide attempt and €48,216 for severe suicidal ideation. Cost-effectiveness acceptability curves were used to examine uncertainty in the QALY analysis, where cost-effectiveness probabilities were calculated using net monetary benefit analysis incorporating a two-stage bootstrapping technique. For suicide attempt, the probability that YAM was cost-effective at a willingness to pay of €47,000 was 39%. For severe suicidal ideation, the probability that YAM was cost-effective at a willingness to pay of €48,000 was 43%. This CEA supports YAM as the most cost-effective of the SEYLE interventions in preventing both a suicide attempt and severe suicidal ideation.Trial registration number DRKS00000214.

Language: en

Keywords

Adolescents; Cost-effectiveness; Intervention; Prevention; School; Suicidal ideation; Suicide attempt