Exploring the identification, validation, and categorization of the cost and benefits of criminal justice in mental health: The PECUNIA project

Background Mental health disorders and their treatments produce significant costs and benefits in both healthcare and non-healthcare sectors. The latter are often referred to as intersectoral costs and benefits (ICBs). Little is known about healthcare-related ICBs in the criminal justice sector and how to include these in health economics research. Objectives The triple aim of this study is (i) to identify healthcare-related ICBs in the criminal justice sector, (ii) to validate the list of healthcare-related ICBs in the criminal justice sector on a European level by sector-specific experts, and (iii) to classify the identified ICBs. Methods A scientific literature search in PubMed and an additional grey literature search, carried out in six European countries, were used to retrieve ICBs. In order to validate the international applicability of the ICBs, a survey was conducted with an international group of experts from the criminal justice sector. The list of criminal justice ICBs was categorized according to the PECUNIA conceptual framework. Results The full-text analysis of forty-five peer-reviewed journal articles and eleven grey literature sources resulted in a draft list of items. Input from the expert survey resulted in a final list of fourteen unique criminal justice ICBs, categorized according to the care atom. Conclusion This study laid further foundations for the inclusion of important societal costs of mental health-related interventions within the criminal justice sector. More research is needed to facilitate the further and increased inclusion of ICBs in health economics research.This research is part of the PECUNIA (ProgrammE in Costing, resource use measurement and outcome valuation for Use in multisectoral National and International health economic evaluAtions) project, which aims to develop a multi-national multi-person multi-sectoral standard for health economics research. This project has received funding from the European Union´s Horizon 2020 research and innovation program under grant agreement No 779292. The authors would like to thank Juan Lluch Cerdà (Spain), Vicente Tort (Spain), Enric Vicens Pons (Spain), Garret Hopkins (UK), Barbara Barret (UK), and seven experts who preferred to remain anonymous, for participating in the expert survey. The authors would also like to thank the discussants and others present at the Fourteenth Workshop on Costs and Assessment in Psychiatry (Venice, Italy), the 11th edition of the lolaHESG (Lowlands Health Economic Study Group) conference (Almen, The Netherlands), the Health Technology Assessment international (HTAi) 2019 Annual Meeting (Cologne, Germany), and the International Health Economic Association (iHEA) 2019 Congress (Basel, Switzerland) for collegial discussions after the presentation of the study results