Integrating universal depression screening into India’s primary healthcare system could generate net savings of Rs 291 billion to Rs 482 billion, according to a new modelling study published in The Lancet Regional Health – Southeast Asia. The estimated savings amount to roughly 0.19–0.32 per cent of the country’s GDP, the researchers said.
The analysis, conducted by experts from PGIMER Chandigarh, NIMHANS Bengaluru and other institutions, modelled the costs and benefits of routinely screening adults for depression in government primary health facilities. It found that screening people aged 20 years and above would be more cost-effective than starting at 30, and that the programme would save money if at least 60 per cent of patients receiving treatment are managed through public healthcare rather than private care.
Currently, depression in India is largely detected through “opportunistic diagnoses” – cases picked up incidentally when patients seek care for other problems, or when they present with overt symptoms. The authors argue that shifting to a population-based screening model could deliver “substantial public health and economic benefits” and strengthen the case for a primary healthcare–oriented mental health system.
Using data from the National Mental Health Survey, National Sample Survey and previous studies, the team projected that a universal programme could also reduce depression‑related suicides by about 15 per cent annually by enabling earlier detection and intervention. The proposed approach is a two‑step strategy: initial screening with the Patient Health Questionnaire‑2 (PHQ‑2), followed by the more detailed PHQ‑9 for those who screen positive, both widely used tools for identifying and monitoring depression severity worldwide.
The authors emphasised that ensuring high diagnostic accuracy through proper training and supportive supervision will be critical to maximising the impact of such a programme. They also noted that while Ayushman Bharat Pradhan Mantri‑Jan Arogya Yojana (AB PM‑JAY) already offers cashless services for 22 mental health–related procedures, including conditions such as schizophrenia, autism and intellectual disability, systematic depression screening at the primary care level could significantly expand the reach and efficiency of mental health services in the country.
