The Southwest Hub?s brief interventions, including New Hope, the Elders Resilience Curriculum, and the combination of these two seek to lower suicidal ideation and attempts among youth 10- 24 years old in the White Mountain Apache Tribe (WMAT). To understand the economic impact of the interventions, their costs and effects will be compared against the status quo practice of surveillance and case-management. Using a five-year time horizon and both a societal and third-party payer?s perspective, we will apply an ingredients-approach to costing that will include both the intervention costs and cost offsets due to prevention of pathology. Health outcomes will be measured as reductions in suicidal ideation using data collected in the Southwest Hub study. A model will convert measurable reductions in suicidal ideation to estimated gains in quality- adjusted-life-years (QALYs) using parameters collected on quality of life survey tools administered to study participants. The resulting incremental cost effectiveness ratio (ICER) will be subjected to sensitivity analysis, and probabilistic methods will generate an uncertainty range. Results of cost-effectiveness analysis will be key for informing tribal communities and the public health sector about the economic case for allocating scarce resources to adopting and scaling these interventions in mental health.
There is little robust evidence on the effectiveness and cost-effectiveness of culturally appropriate mental health preventive interventions for Native Americans. The Southwest Hub study provides an opportunity to systematically compare the cost-effectiveness of two interventions on their own and in combination to inform policy makers about the economic impact and benefits to the healthcare sector and to society as a whole.
