Talking therapy: impacts of a nationwide mental health service in England

Mental health problems impose significant costs, yet healthcare systems of-ten overlook them. We provide the first causal evidence on the effectiveness of a nationwide-scaled mental health service in England for treating depression and anxiety using non-experimental data and methods. We exploit over-subscription and resulting exogenous variation in waiting times across areas and time for identification, based on a novel dataset of over one million patients. We find that treatment improves mental health and reduces impairment in work and social life. We provide suggestive evidence that it enhances employment. Impacts vary across patients and services. Nevertheless, the programme is highly cost-effective.