Assessing the Economic Costs of Serious Mental Illness
What do mental disorders cost the nation? The costs of health care are considered one of the greatest challenges in U.S. public policy. In 2006, health care costs reached 16% of the nation’s gross domestic product, on a path to reach 20% by 2016. While mental disorders contribute to these costs at an estimated 6.2% of the nation’s spending on health care, the full economic costs of mental disorders are not captured by an analysis of health care costs. Unlike other medical disorders, the costs of mental disorders are more "indirect" than "direct."
The costs of care (e.g., medication, clinic visits, or hospitalization) are direct costs. Indirect costs are incurred through reduced labor supply, public income support payments, reduced educational attainment, and costs associated with other consequences such as incarceration or homelessness. Another kind of indirect cost results from the high rate of medical complications associated with serious mental illness, leading to high rates of emergency room care, high prevalence of pulmonary disease (persons with serious mental illness smoke 44% of all cigarettes in the United States), and early mortality (a loss of 13 to 32 years). While indirect costs have been challenging to quantify, they are critical for informing public policy. Once we assess the key components of the economic burden of mental disorders, we can have a more informed discussion about what should be invested to prevent and treat these illnesses.
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