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Life sciences · Journal article
Actas Españolas De Psiquiatría · August 15, 2026
Encouraging direction, but not yet definitive.
This pilot cost-effectiveness analysis suggests that a remote integrated primary care and psychiatry model (MAP-PSI) may reduce school absenteeism and prevent suicide attempts at modest cost in a rural Mexican population of youth with depressive symptoms. However, the study lacks a rigorous control design, suicide outcomes are model-projected rather than observed, and findings derive from a single municipality and are thus not yet generalizable.
Pilot cost-effectiveness analysis with unequal comparison group. Adolescents and young adults aged 15–25 years residing in a rural municipality in Mexico; 932 completed screening (88.2% of 1,057 recruited), mean age 16.63 years (SD 1.53), 60.51% female.. Intervention: Remote Primary Care and Psychiatry Model (MAP-PSI)—remote integrated mental health care delivery. Compared with: Community usual care (CUC). n = 932. One rural municipality in Mexico.
Of 1,057 recruited, 932 completed screening (88.2%); mean age 16.63 years (SD 1.53), 60.51% female MAP-PSI delivered care to 932 youths vs 16 under usual care Prevention of 12,195 school absenteeism days at incremental cost of $7.84 USD per day avoided
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Clinicians and policymakers considering remote mental health models for rural youth should note this pilot finding as suggestive but not conclusive; the imbalance in comparison groups, model-projected suicide outcomes, and single-site setting mean this cannot yet guide practice decisions without replication in rigorous, adequately powered trials.
A pilot cost-effectiveness analysis from a single rural Mexican municipality with unequal comparison groups (932 vs 16), surrogate endpoints, and model-projected rather than observed suicide outcomes; real findings but limited by design and generalizability.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians and policymakers considering remote mental health models for rural youth should note this pilot finding as suggestive but not conclusive; the imbalance in comparison groups, model-projected suicide outcomes, and single-site setting mean this cannot yet guide practice decisions without replication in rigorous, adequately powered trials.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background: Community- and school-based interventions focused on mental health promotion and early detection of depressive symptoms have proven to be cost-effective. Our objective was estimated the costeffectiveness ratio of the remote and pilot Primary Care and Psychiatry Model (MAP-PSI) compared with community usual care (CUC) in a rural municipality in Mexico. Methods: We analyzed all adolescents and young adults aged 15–25 years who received care between November 2023 and November 2024. Effectiveness measures included care-seeking behavior, school absenteeism prevented, suicide attempts avoided and suicides prevented. Direct and indirect costs including lost workdays, were considered. Incremental Costs-Effectiveness Ratios (ICERs) and deterministic sensitivity analyses were performed. Results: Of 1057 recruited participants, 932 completed screening (88.2%); mean age was 16.63 years ± standard deviation (SD) 1.53, and 60.51% were female. MAP-PSI delivered mental health care to 932 youths compared with 16 under CUC and was associated with the prevention of 12,195 school absenteeism days, at an incremental cost of $7.84 USD per absenteeism day avoided. Based on model projections, the intervention reduced expected suicide attempts from 13 to four cases; corresponding to nine suicide attempts avoided at an estimated incremental cost of $10,622.10 USD per suicide attempt avoided. Sensitivity analyses suggested that lower intervention effectiveness substantially increased ICERs under conservative scenarios. Conclusions: The MAP-PSI is a cost-effective strategy for reducing suicidal behavior and school absenteeism in young people with depressive symptoms living in rural and Indigenous communities.
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