Study: MH Creates Significant Economic Issues
> 5/22/2008 1:05:53 PM

The cost of treating mental illness and its many comorbidities weighs on our health care system, and the price of its negative influence on productivity rates has been well-documented. Experts have now made the unfortunate economic effects of severe mental illness even clearer on an personal level by framing them in terms of individual earning power.

Researchers reporting in the American Journal of Psychiatry based their study on data gleaned from the NCS-R or National Comorbidity Survey, a large-scale standardized questionnaire administered to Americans aged 18-64 that was designed to provide a comprehensive portrait of the average American household’s health status. From this database they used predictive demographic techniques to estimate the relative earnings of control subjects compared to those who reported suffering from some form of major mental illness in the 12 months preceding the survey. Their conclusions were stark: the total societal difference in yearly earnings amounted to nearly $200 billion, placing the estimated individual income discrepancy at more than $16,000 - that is to say that, on average, the yearly earning power of severely mentally ill individuals was $16,000 lower than that of their control peers, including those who’d struggled with less debilitating disorders during the same period. The number was also nearly three times as high among men, though the reason for this particular pattern was not explored in depth.

A large part of the trend stems from employment discrimination against individuals with severe mental illness, or an inability for said individuals to acquire income in the first place. For example, a worker afflicted by severe bipolar disorder and the often debilitating side-effects of related medical treatments will present a compromised ability to perform in demanding professional situations. He or she may then be relegated to a lower-earning, less complex profession regardless of intelligence, qualification or motivational factors. On one hand, any gainful employment is a victory for someone suffering from such a damaging condition, and in that sense the fact that 75% of the discrepancy can be attributed to lower average earnings rather than widespread unemployment is encouraging. Still, a 25% unemployment rate remains reason for alarm.

The conditions deemed relevant to this study were those that are both severe and relatively common: bipolar disorder, major depressive disorder, non-affective psychosis, panic disorder and any condition that prompted serious suicide attempts or led to a disability period lasting at 30 days over the preceding 12 months. The affected population is not a small one as a surprising 6 to 8 percent of Americans aged 18-64 suffer from one or more of these conditions. Researchers’ decision to limit the focus of their study to the most debilitating conditions may have led them to underestimate the discrepancies created by mental illness on the whole, but their research implied that minor disorders do not have the same dramatic effect on earnings, stating that their influence was “not statistically significant.” This is a fortunate finding, narrowing the field of conditions on which health care researchers should focus in the near future.

The larger conclusion drawn from this study illustrates that systematically devoting greater talent and funding to both treatment and research in the mental health field will inevitably save money by reducing the discrepancies in productivity characterized by individual earning potential. Lead researcher Ronald Kessler asserted that mental illness actually produces far greater public health costs than more commonly publicized afflictions like cancer and cardiovascular disease. He also stated that estimated discrepancies were most likely conservative due to the fact that the data did not include individuals who were hospitalized or incarcerated and included very few cases of notoriously difficult conditions like autism and schizophrenia. Still, studies like this one will prove essential in reinforcing the societal cost of mental illness to employers and insurers who would debate the value of providing coverage. Providing treatment for employees with mood disorders or other conditions that complicate their productivity rates would, in most cases, prove to be a sound investment over time.

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