Universal screening for depression in India’s primary healthcare system could bring substantial economic returns, saving between RS 291 billion and Rs 482 billion, according to a study published in The Lancet Regional Health – Southeast Asia.
The projected savings — amounting to 0.19% to 0.32% of India’s GDP — stem from early detection, reduced disease burden and treatment routed through public health facilities, the researchers said. The team included scientists from PGIMER, Chandigarh, and NIMHANS, Bengaluru.
The study found that screening people aged 20 and above is more cost-efficient than limiting the programme to older adults. But for the effort to save money, at least 60% of diagnosed patients must be treated within the public system.
India currently relies on “opportunistic diagnoses,” when patients are identified during unrelated tests or clinical consultations. Under Ayushman Bharat PM-JAY, 22 mental-health procedures are available as cashless care, including for schizophrenia, autism, and intellectual disability, according to a March 2025 health ministry statement.
The researchers said their findings point to “substantial public health and economic benefits,” should India embed population-level screening into routine primary care.
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.
