People caught up in humanitarian crises carry a heavy burden of mental health problems, yet the economic evidence needed to decide how scarce resources should be spent on mental health and psychosocial support remains thin. That is the central conclusion of a systematic review published in the journal Conflict and Health, which set out to assess what is known about the cost-effectiveness of such interventions among crisis-affected populations.
The review team searched Medline, Embase, PsycInfo, EconLit and Global Health for English-language primary studies published between 1 January 2000 and 31 May 2026. The search was first run in July 2024 and updated on 11 June 2026. To be included, studies had to be full economic evaluations of interventions with an explicit mental health and psychosocial support component; partial economic evaluations and standalone modelling studies were excluded. Records were screened by two reviewers and the findings were synthesised narratively rather than through meta-analysis.
Methodological quality and reporting standards were assessed using a modified BMJ Checklist and the CHEERS 2022 Checklist. The authors note one important limitation of their approach: risk of bias in the underlying effectiveness studies was not assessed separately.
After screening, 12 studies involving 4,478 participants met the inclusion criteria. Eleven of the evaluations were conducted alongside randomised controlled trials, nine included cost-utility analysis, and nine were published from 2020 onwards, indicating that this field is young but growing rapidly.
The geographic spread was split evenly: six studies were conducted in high-income countries and six in low- and middle-income countries, although only one took place in a low-income country. That imbalance matters, because the settings where humanitarian needs are greatest are precisely where the economic evidence base is weakest.
Eight of the twelve studies reported findings that their authors interpreted as supporting cost-effectiveness or potential cost-effectiveness. However, no single intervention type emerged as consistently superior. Five studies evaluated low-intensity interventions developed by the World Health Organization, and all five reported favourable cost-effectiveness findings, making this the most coherent signal in the literature.
The review also identified patterns in how economic results depend on measurement choices. In three studies, the economic case was more favourable or more conclusive when condition-specific outcome measures were used rather than quality-adjusted life years. In three other studies, including productivity losses in the analysis strengthened the economic argument for the intervention. These details suggest that the apparent value of an intervention can hinge on which outcomes and cost categories analysts choose to count.
A major obstacle to drawing overall conclusions was heterogeneity. The studies varied substantially in the interventions tested, the comparators used, the time horizons of the analyses, the economic perspectives adopted, the outcome measures and the cost-effectiveness thresholds applied. As a result, direct comparison between studies was largely impossible.
The authors’ overall verdict is cautious: several forms of mental health and psychosocial support may be cost-effective, but the limited evidence base prevents firm conclusions about which approaches offer the greatest value. They call for further economic evaluation, particularly in low- and middle-income countries, to support decisions about how limited resources for mental health and psychosocial support can be used most effectively.
The review received no external funding and was not registered. It appears as an open-access article in Conflict and Health, published on 17 October 2026.
Subject of Research: Cost-effectiveness of mental health and psychosocial support interventions for populations affected by humanitarian crises
Article Title: Economic evaluation of mental health interventions among crisis‑affected populations: a systematic review
Article References: Danny, T., Blossom, O., Zia, S., & Bayard, R. (2026). Economic evaluation of mental health interventions among crisis‑affected populations: a systematic review. Conflict and Health. https://doi.org/10.1186/s13031-026-00848-4
Image Credits: AI Generated
DOI: 10.1186/s13031-026-00848-4
Keywords: systematic review, cost-effectiveness, mental health, humanitarian crises, psychosocial support, MHPSS, economic evaluation, QALYs, low- and middle-income countries, WHO interventions, Conflict and Health, cost-utility analysis
News Source: Glenn Wilkins. (October 28, 2026). Systematic review finds limited evidence on cost-effectiveness of mental health care in crises. Scienmag.
