Screening for depression under govt primary healthcare may save up to Rs 482 billion: Study

Integrating universal screening for depression in India’s primary healthcare system could be expected to generate a net savings of Rs 291 billion to Rs 482 billion, a study published in The Lancet Regional Health Southeast Asia has estimated.

Researchers, including those from the Postgraduate Institute of Medical Education and Research (PGIMER) in Chandigarh and National Institute of Mental Health and Neurosciences (NIMHANS) in Bengaluru, said the savings were equivalent to 0.19 per cent to 0.32 per cent of the country’s gross domestic product.

People aged 20 and older would be cheaper to screen than those above 30, the study found.

The researchers also noted that the screening programme could save money if at least 60 per cent of patients receiving treatment go through public healthcare facilities.

Current practices involve ‘opportunistic diagnoses’ — in which diagnosis is incidental, such as through tests done for other reasons — and managing patients showing symptoms of the mental disorder.

Cashless healthcare services related to 22 procedures of the mental disorder specialty, including intellectual disability, schizophrenia and autism, are available to those eligible under the health benefit package of Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana (AB PM-JAY), according to a March 2025 statement by the Ministry of Health and Family Welfare.

The study indicates “substantial public health and economic benefits” of integrating population-based depression screening into the primary healthcare system.

The findings also support the case for a primary healthcare oriented-health system, they added.

Data from National Mental Health Survey and the National Sample Survey, along with those from previously published studies were analysed.

“The (universal depression screening) program is expected to generate net savings of Rs 291 billion (USD 3.7 billion) to Rs 482 billion (USD 6.1 billion), equivalent to 0.19 per cent to 0.32 per cent of GDP,” the authors wrote.

“Expanding coverage to individuals aged 20 years and above, along with ensuring high diagnostic accuracy through quality training and supportive supervision, will be key to sustaining and maximising the programme’s impact,” they added.

The population-based screening is also projected to reduce depression-related suicides by about 15 per cent yearly, highlighting the importance of early detection and intervention in averting fatal outcomes, the authors said.

“Our analysis strongly supports the adoption of a universal two-step screening strategy for depression, using PHQ-2 (questionnaire) followed by PHQ-9 within India’s government primary healthcare system,” they said.

Patient Health Questionnaire-2 and 9 are designed for screening, diagnosing and monitoring depression severity in adults, and used widely around the world in diverse settings, including primary care and research.