Published Jan. 15, 2017
Journal of Affective Disorders

Cognitive behavioral therapy provided in the home to depressed, low-income mothers should be covered by third-party insurers and healthcare providers, not only because it is less costly than current medical standards but also because it can reduce maternal depression by 346 days over a projected three-year period.

This “bench-to-bedside” cost-effectiveness analysis, led by Robert Ammerman, PhD, ABPP, scientific director of Every Child Succeeds (ECS), shows that in-home cognitive behavioral therapy (IH-CBT) has the potential to impact both how depression is treated for  low-income mothers and how third-party payers cover it.

Researchers followed 93 depressed, low-income new mothers enrolled in ECS home-visiting programs in Southwestern Ohio and Northern Kentucky. Some received home visits only while others also received cognitive behavior therapy.

Cost-utility analysis showed that IH-CBT is more effective than home visits only and antidepressant medications. The combined approach is expected to be cost-effective more than 99.5 percent of the time across three insurer willingness-to-pay thresholds ($25,000, $50,000 and $100,000) over three years. Mothers also reported improved social support and day-to-day functioning, and lowered psychological stress.

Low-income mothers face higher-than-average risks of maternal depression, yet in many cases, they lack access to mental health resources and/or the financial ability to pay for treatment. This can leave mothers, and their children, at risk of suffering long-term consequences.

“If we’re going to make an impact on a larger scale, and if we’re going to change policy, we need data that can convince third-party payers who pay for these services,” Ammerman says. “If I were Medicaid or another third-party payer, I’d pursue this approach because it’s cost-effective.”