Investing in the future: How better mental health benefits everyone

In 2025, the total burden from mental health conditions stands at approximately 183 million DALYs. The majority of this burden, amounting to 170 million DALYs, is attributed to morbidity, measured in YLDs.¹Global Burden of Disease 2021, Institute for Health Metrics and Evaluation. Data shown for 2025 to 2050 are projections from Stein Emil Vollset et al., 2024, “Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021.” When comparing this burden with other NCDs, the morbidity from mental health conditions is considerably higher than that of the four leading non-mental-health diseases, which include cardiovascular diseases, chronic respiratory diseases, diabetes and kidney diseases, and cancers, combined.²Global Burden of Disease 2021, Institute for Health Metrics and Evaluation. This means that mental health conditions cause more years of poor health globally than the four major NCDs do.

In 2025, the total disease burden from NCDs is estimated to reach approximately 1.8 billion DALYs.¹Global Burden of Disease 2021, Institute for Health Metrics and Evaluation, used with permission; all rights reserved. Data shown for 2025 to 2050 are projections from Stein Emil Vollset et al., 2024, “Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021.” Mental health conditions contribute meaningfully to this burden, accounting for 290 million DALYs—183 million directly and 107 million indirectly from their exacerbation of other NCDs.²Associated burden is calculated by 1) Identifying an estimate of the additional relative risk for people with a prior mental health condition diagnosis, 2) Calculating the population attributable fraction (PAF) for that condition pair, and 3) Applying this PAF to the disease burden for the relevant non-mental health NCDs. This means that roughly one in six DALYs from NCDs can be attributed to mental health conditions. The indirect burden encompasses the effects of pre-existing mental health conditions that increase the likelihood and severity of other NCDs. For instance, depressive disorders increase the risk of cardiovascular diseases by three times and digestive system diseases by more than four times.³Xin Han, et al., “Disease trajectories and mortality among individuals diagnosed with depression: a community-based cohort study in UK Biobank,” Molecular Psychiatry, Volume 26, May 2021. Depressive disorders can make it harder for an individual to sleep well, exercise, quit smoking, or prioritize other well-being measures that could reduce the risk of developing another chronic disease.

As another example, research shows that substance use disorders greatly increase the risk of NCDs. Alcohol use alters the gut microbiome, enabling toxins to enter the bloodstream and increasing the risk of seven types of cancer.⁴Carrie Daniel-MacDougall, “How does alcohol affect the microbiome?” The University of Texas MD Anderson Center, April 11, 2024. Of the three million alcohol-related deaths that occur every year, more than half are due to NCDs like cancer, digestive diseases, and cardiovascular diseases.⁵“Alcohol use,” NCD Alliance, accessed March 2025.

These examples underscore the interconnectedness of mental health conditions and other NCDs, emphasizing the importance of integrated strategies to address these conditions effectively.

Many NCDs, such as cardiovascular disease, typically develop and worsen in older age, as evidenced by nearly half of the disease burden occurring in populations aged 60 and older.¹Global Burden of Disease 2021, Institute for Health Metrics and Evaluation, used with permission; all rights reserved. Burden without intervention for 2025-2050 are projections from Stein Emil Vollset et al., 2024, “Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021.” Mental health conditions are the opposite: More than half of the mental health disease burden affects individuals who are under 40 years old. This highlights the importance of early intervention for mental health conditions, which can not only improve immediate outcomes for health and workforce productivity but also set individuals up for better health throughout their lifespan.

There are also sex-based differences in disease burden from mental health conditions. Almost 80 percent of substance use disorder deaths are among men, underscoring the broader crisis of deaths of despair—suicide, drug overdoses, and alcohol-related diseases—which disproportionately impact men worldwide. Meanwhile, although women experience a lower overall burden from mental health conditions compared with men, they lose substantially more years to disability from mental disorders such as anxiety and depression, leading to lower quality of life. These disparities underscore the importance of considering sex-specific approaches when addressing the mental-health-related NCD burden.

On the current trajectory, the global burden of mental health conditions is projected to reach 365 million DALYs by 2050. However, implementing proven mental health interventions at scale could radically reduce this burden. By scaling interventions such that 90 percent of affected individuals receive the evidence-based services and support they need (in alignment with The Kennedy Forum’s 90-90-90 aspirational goals¹These goals are that 90 percent of individuals would be screened for mental health conditions or substance use disorders; 90 percent would receive evidence-based services and supports, and 90 percent of those treated would be able to manage their symptoms and achieve recovery. For more, see “Alignment for Progress Goals for 2033: 90-90-90,” The Kennedy Forum.), the mental health disease burden could be reduced by approximately 41 percent or 150 million DALYs, preventing 1.6 million deaths in 2050.

Advancements in healthcare and technology are leading to longer lifespans, with life expectancy projected to increase by nearly five years over the next 25 years.²Stein Emil Vollset et al., “Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021,” The Lancet, May 18, 2024, Volume 403, Issue 10440. However, longer lives do not necessarily mean that people will spend all those years in good health. Expanding access to evidence-based mental health interventions could not only improve overall lifespan but also increase healthspan—the number of years of life lived in good health. By 2050, these interventions could increase average life expectancy by three months and health-adjusted life expectancy by 1.1 years per person—similar to the global impact of eliminating obesity.

Among the evidence-based, cost-effective interventions examined,¹Proven interventions recommended in international guidelines and national clinical practice guidelines, assessed for relative cost-effectiveness in each income setting examined using World Bank income archetypes and reviewed by experts in the relevant field, including over 70 interventions across approximately 100 papers. It’s important to note that while this analysis includes several health promotion and prevention interventions such as weight management, it doesn’t comprehensively cover interventions addressing broader socioeconomic challenges (for example, food insecurity). These interventions will have cascading impacts on the mental health and NCD burden and are essential cost-effective solutions for addressing root causes and preventing disease at a population level. therapeutic interventions account for over 82 percent of the potential impact by 2050.²It’s important to acknowledge that while health promotion and prevention strategies likely offer a viable opportunity to reduce disease burden, the MHI model doesn’t fully capture this due to limited robust evidence on these interventions. Since our model is grounded in published clinical studies, therapeutic interventions appear to play an outsized role, reflecting the abundance of research available in this area. Expanding access to established treatments such as psychotherapy and psychiatric medications—which alone could avert nearly 80 million DALYs—will be key to reducing the global mental health disease burden. Additionally, emerging therapeutic options such as digital therapies³Examples include internet-based cognitive behavioral therapy, digital peer support communities, gamified interventions, and mental health applications. are gaining recognition for their accessibility and effectiveness,⁴Kathleen Kara Fitzpatrick et al., “Delivering cognitive behavior therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (Woebot): A randomized controlled trial,” JMIR Mental Health, April–June 2017, Volume 4, Number 2. particularly in low-resource settings.

Scaling these interventions will require substantial investment to address access and cost barriers to treatment. However, current funding for mental health conditions remains severely inadequate. Multiple expert groups, including The Lancet Commission on Global Mental Health and Sustainable Development, United for Global Mental Health (UGMH), and the Coalition for Mental Health Investment (CMHI), have reached the same conclusion that mental health interventions are systematically underfunded, undermining their potential impact.

Based on a review of high-quality peer-reviewed studies on intervention costs, which included approximately 140 estimates across over 30 countries, cost-effective mental health interventions on average cost $800 per DALY in low- and lower-middle-income countries and $6,800 per DALY in upper-middle- and high-income countries, resulting in a global average of $4,300 per DALY.¹Based on cost per DALY analysis of approximately 140 estimates, with interventions defined as cost-effective based on WHO CHOICE thresholds (where cost per DALY is less than three times GDP per capita) across 33 countries, from the Tufts Cost-Effectiveness Analysis Registry and Disease Control Priorities Economic Evaluation for Health database. There is limited data available to quantify the relative costs associated with lower versus higher coverage; however, the authors anticipate that marginal costs would be affected. If mental health interventions were scaled to reach 90 percent of those in need today, it would require a global investment of $350 billion in 2025.²Based on DALYs averted through scaling interventions, weighted by income archetype to get total costs.

This high-level estimate is limited by the current cost-effectiveness data available, especially in low- and lower-middle-income countries, where delivery costs can vary widely across studies and countries. However, this estimate is higher but similar in scale to others, such as United for Global Mental Health (UGMH), which estimated a $200 billion mental health financing gap based on the difference between current and recommended allocations of health spend by country.³United for Global Mental Health. Financing Mental Health: Current Status and Future Prospects. This analysis compared country mental health budgets to the recommendations in “The Lancet commission on global mental health and sustainable development”—allocating at least 5 percent of healthcare budgets to mental health in low- and middle-income countries and 10 percent in high-income countries. The difference between these two funding estimates arise from differing methodologies: MHI used a bottom-up approach to assess the impact of scaling specific evidence-based interventions to 90 percent of affected individuals, while UGMH conducted a top-down analysis to determine the funding needed to meet recommended spending levels.

However, both approaches point to the same conclusion—current levels of investment in mental healthcare are inadequate to address the growing mental-health-related burden and support populations to thrive in the “brain economy.”⁴The brain economy is an economic paradigm that prioritizes “brain capital” as its core asset, responding to the growing demand for brain skills in the modern workforce. Brain capital is a form of human capital that combines brain health with essential cognitive, emotional, and social skills such as analytical thinking, creativity, adaptability, and empathy. Based on “Brain gain: How improving brain health benefits the economy,” World Economic Forum, September 9, 2024.

Scaling mental health interventions could unlock $4.4 trillion in GDP by 2050 by enabling 60 million individuals to participate in the global labor force and enhance their productivity through improved health.

The economic impact at stake is estimated through five main levers. Increasing access to mental health interventions could lower absenteeism, short- and long-term absences from the workforce. Fewer premature deaths would let more people live long, fulfilling lives, both personally and professionally. Informal caregivers of those with mental health conditions—many of whom leave the labor force due to the logistics and emotional toll of care responsibilities—would have more freedom and flexibility to pursue their personal and economic goals.¹Note that the estimates for increased participation from caregivers are only for OECD countries and women aged 50 years of age and above, due to limitations on data available showing the proportion of informal caregivers by country. Better mental health would enhance productivity by reducing presenteeism for adults already in the labor force. Finally, preventing and reducing burden associated with mental health conditions in children through mental health interventions would not only improve their well-being and levels of educational attainment but also enable them to develop into healthier, more capable adults who can contribute more effectively to the economy in the future.²Johns Hopkins Bloomberg School of Public Health and United Nations Children’s Fund, On My Mind: How adolescents experience and perceive mental health around the world, JHU and UNICEF, Baltimore and New York, May 2022.

When considering the additional impact mental health interventions can have on disease burden, each dollar invested in scaling mental health interventions could have an economic return of $5 to $6 in global GDP.³Calculated based on the impact of 90 percent coverage of mental health interventions in 2025, assuming all else equal. GDP uses constant prices and exchange rate, with reference year for real GDP as 2022. Calculation only accounts for marginal costs and doesn’t include fixed costs. Prioritizing mental health saves and improves lives, reduces healthcare costs, and has the potential to contribute to a thriving economy.