ArticleActas espanolas de psiquiatria2026
Cost-Effectiveness of the Remote Primary Care and Psychiatry Model (MAP-PSI) for Depression in Youth Living in Rural and Indigenous Communities.
Article in Actas espanolas de psiquiatria, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCommunity- and school-based interventions focused on mental health promotion and early detection of depressive symptoms have proven to be cost-effective. Our objective was estimated the cost-effectiveness ratio of the remote and pilot Primary Care and Psychiatry Model (MAP-PSI) compared with community usual care (CUC) in a rural municipality in Mexico.
methodsWe analyzed all adolescents and young adults aged 15-25 years who received care between November 2023 and November 2024. Effectiveness measures included care-seeking behavior, school absenteeism prevented, suicide attempts avoided and suicides prevented. Direct and indirect costs including lost workdays, were considered. Incremental Costs-Effectiveness Ratios (ICERs) and deterministic sensitivity analyses were performed.
resultsOf 1057 recruited participants, 932 completed screening (88.2%); mean age was 16.63 years ± standard deviation (SD) 1.53, and 60.51% were female. MAP-PSI delivered mental health care to 932 youths compared with 16 under CUC and was associated with the prevention of 12,195 school absenteeism days, at an incremental cost of $7.84 USD per absenteeism day avoided. Based on model projections, the intervention reduced expected suicide attempts from 13 to four cases; corresponding to nine suicide attempts avoided at an estimated incremental cost of $10,622.10 USD per suicide attempt avoided. Sensitivity analyses suggested that lower intervention effectiveness substantially increased ICERs under conservative scenarios.
conclusionsThe MAP-PSI is a cost-effective strategy for reducing suicidal behavior and school absenteeism in young people with depressive symptoms living in rural and Indigenous communities.
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