Article Abstract

Article Abstract

Online ISSN: 1099-176X Print ISSN: 1091-4358
The Journal of Mental Health Policy and Economics
Volume 29, Issue 3, 2026. Pages: 89-96
Published Online: 1 September 2026

PERSPECTIVE: Community‑Engaged Research Methods in Health Economics Approaches to Mental Health and Substance Use Research

Patrick F. Hibbard,^1* Sierra Castedo de Martell,² Tess K. Drazdowski,¹ Ashli J. Sheidow¹

¹PhD, Chestnut Health Systems – Lighthouse Institute, Chicago, IL, USA.
²PhD, The Phoenix, Denver, CO, USA.

*Correspondence to: Patrick F. Hibbard, PhD, Chestnut Health Systems – Lighthouse Institute, 221 W. Walton Street, Chicago, IL 60610, USA.
E-mail: pfhibbard@chestnut.org

Source of Funding: The authors declare that financial support was received for the research and/or publication of this article. This work was supported in part by grants R24DA051950 (PH, TD, AS), R34DA057639 (TD), U24DA064498 (PH, TD, AS), K23DA048161 (TD) from the National Institute on Drug Abuse, National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Abstract

This perspective article argues that health economics research on mental health and substance use can be more relevant, credible, and implementable when affected communities help define costs, outcomes, model structures, assumptions, and financing questions. The manuscript outlines a practical, mental health/substance use–specific approach for incorporating community-engaged research across the economic research life cycle, including early scoping, selection of locally meaningful outcomes alongside standard metrics such as QALYs, co-production of model structures and parameters, method selection based on decision context, and transparent reporting of engagement inputs. Examples from recovery support services, peer-run organizations, medications for opioid use disorder in carceral settings, and naloxone distribution illustrate feasible approaches. Recommendations include early engagement, fair compensation, reciprocal dissemination, and incremental movement toward deeper partnership to produce economic evidence that is rigorous, trusted, and actionable.

Background: Mental health (MH) and substance use (SU) conditions generate large, multi-sector burdens. Health economics studies can guide smarter investment, but they tend to be conducted late in the research cycle and may omit costs and outcomes prioritized by affected communities. Community-engaged research offers practical ways to improve relevance and credibility by co-defining what counts as cost and benefit, how services flow, and what success means locally. Though health economics research includes many efforts to incorporate community voices, like Patient and Public Involvement (PPI) efforts, the field lacks specific guidance for engaging communities concerning mental health and substance use research, and little is known about the depth of involvement due to inconsistent reporting of community engagement efforts.

Aims: To propose a formalized, MH/SU-specific approach for further embedding community engagement throughout health economics research – scoping, measurement, modeling, interpretation, and financing – where analyses substantially inform real-world decisions while preserving comparability to standard metrics.

Results: We outline concrete steps that teams can adopt: (i) Complement early study activities with meaningful engagement including a brief plan that names partners, roles, decision rights, and compensation; (ii) Co-select costs and outcomes to elevate locally meaningful endpoints (e.g., housing stability, treatment retention) alongside standard measures (e.g., QALYs); (iii) Co-produce model structure and parameters aiming for a state-transition or stock-and-flow diagram or a “scenario bank” for sensitivity and threshold analyses; (iv) Match method to decision – CEA/CUA for comparability, CBA/ROI when cross-sector trade-offs must be monetized, and BIA when payers need near-term affordability; (v) Plan for implementation and financing, including documentation and contracting steps (“pilot-to-payment”) and alternative funding paths for low-barrier models that operate with some measure of anonymity for clients (e.g., some recovery community centers or peer-run mental health organizations).

Discussion and Implications: We recommend transparent reporting of engagement inputs and their effects on costs, outcomes, assumptions, and uncertainty, plus reciprocal practices (e.g., fair compensation, authorship where warranted, and plain-language briefs). Taken together, these steps can advance health economics research focused on MH/SU, helping the field to be more trusted, implementable, and likely to improve lives.

Received 31 October 2025; accepted 3 June 2026