The relative value of mental health for pandemic response: A discrete choice experiment with stakeholders and the general population in Europe.

Psychological distress accounted for a greater share of relative importance in pandemic decision-making than hospital admissions.

• Psychological distress accounted for 34% of the relative importance in decision-making.
• Hospital admissions accounted for 30% of the relative importance in decision-making.
• Restrictions on mobility exerted the least influence on choice among the four attributes.
• The four attributes assessed were hospital admissions, psychological distress, employment loss, and movement restrictions.

On average, respondents required 0.61 fewer hospitalisations per 100,000 to accept a 1% increase in psychological distress.

• This trade-off metric was derived from a discrete choice experiment (DCE) grounded in random utility theory.
• The DCE asked participants to assess six pairs of hypothetical countries differing in four pandemic policy consequence attributes.
• The sample included 1615 members of the general population and 145 health stakeholders across eight European countries.

Health policy stakeholders placed greater emphasis on reducing psychological distress compared to the general population.

• Stakeholders were also more willing to accept restrictions on mobility than the general population.
• The stakeholder sample consisted of 145 health stakeholders across Belgium, France, Germany, Italy, the Netherlands, Spain, Sweden, and the United Kingdom.
• The general population sample consisted of 1615 participants from nationally representative samples across the same eight countries.

Negative attitudes toward individuals with mental health problems or those hospitalised due to COVID-19 were associated with lower prioritisation of reductions in psychological distress.

• Respondents who held more negative views towards individuals with mental health problems were significantly less likely to prioritise reductions in psychological distress.
• Respondents who held more negative views towards those hospitalised due to COVID-19 were also significantly less likely to prioritise reductions in psychological distress.
• This finding applied across both the general population and stakeholder samples.

A discrete choice experiment was administered via online survey to assess stated preferences for mental health relative to other wellbeing domains across eight European countries.

• The DCE was grounded in random utility theory.
• Participants were drawn from Belgium, France, Germany, Italy, the Netherlands, Spain, Sweden, and the United Kingdom.
• The general population sample was nationally representative (n=1615) and the stakeholder sample included 145 health policy stakeholders.
• Each participant assessed six pairs of hypothetical countries differing in four attributes: hospital admissions, psychological distress, employment loss, and movement restrictions.

Health policies during public health emergencies often prioritised physical over mental health, prompting the investigation of whether these decisions reflected societal values.

• The study was motivated by concerns that pandemic health policies did not reflect societal values with respect to mental health.
• The study examined how priorities align between the general population and health policy stakeholders.
• The research context was the COVID-19 pandemic and its policy responses across Europe.