The Costs of Failing to Provide Appropriate Mental Health Care
The effects of mental disorders, which strike a substantial portion of
Americans, extends far beyond those who are in direct need of services. Mental
disorders create a burden on our health care system because patients with
untreated psychological disorders are heavy users of medical
service. In addition mental disorders have a direct effect on our economy
because they result in diminished productivity in the workplace. Providing
appropriate mental health care helps those who suffer from psychological
disorders, saves valuable health resources, and restores productivity in the
Mental disorders affect a substantial portion of Americans including children
and older Americans.
* Right now, an estimated 15-18% of Americans, including 14 million children,
suffer from a diagnosable mental disorder.
* Fifty to 70% of usual visits to primary care physicians are for medical
complaints that stem from psychological factors.
* Anxiety and depression are among the six most common conditions seen in family
* In any one-month period, nearly 8 million Americans suffer from depression. As
many as one in five Americans will suffer at least one major episode of
depression during their lifetimes.
* Twenty-five percent of patients seen by primary care physicians have
* A random sample of elderly residents in Medicaid facilities found that nearly
80% of the residents had moderate to intense needs for mental health care.
Mental disorders are real and debilitating. They result in lost productivity
that affects all Americans.
* In l990, major depression alone cost an estimated $23 billion in lost work
* Minor depression, which affects more people, may account for 51% more
disability days than major depression.
* Mental disorders often are more disabling than chronic physical illnesses
including high blood pressure, gastrointestinal problems (e.g., ulcers), and
*Mental disorders are the health condition that most limits the ability to work.
In fact, they are the third most limiting health condition in terms of
performing major daily activities, preceded only by cancer and stroke.
*A three-year study of a large corporation showed that 60% of employee absences
were due to psychological problems.
*Individuals with major depression were found to be more than 4 times more
likely to take disability days than non-depressed employees and 3 times more
likely to miss time from work.
*Workers testing positive for drug use were two and a half times more likely to
be absent than workers who did not test positive. In 1980, alcoholism alone cost
America 500 million lost work days.
* The cost of lest productivity due to mental disorders can be measured in real
*A 1985 government report estimates that mental illness and substance abuse cost
Americans $77.2 billion in lost income.
*1989 payments for stress-related disability claims totaled $380 million in
California alone, according to the National Council on Compensation Insurance.
Providing appropriate mental health care saves valuable health care resources...
* Patients with mental disorders are heavy users of medical services, averaging
twice as many visits to their primary care physicians of patients without mental
* When appropriate mental health services are made available, this heavy use of
the system often decreases, resulting in overall health savings.
* Cost offset studies show a decrease in total health care costs following
mental health interventions even when the cost of the intervention is included.
* In addition, cost offset increases over time, largely because over time,
patients continue to decrease their overall use of the health care system, and
don't require additional mental health services.
...and restores productivity in the workplace
* A review of 58 studies of the effectiveness of psychotherapy for depression
found that after depressed patients were treated, 77% scored significantly
better on evaluations than depressed patients who received no treatment. Eighty
percent of the treated group scored better than wait-listed controls.
* In a study of 742 substance abuse patients undergoing a variety of treatments,
alcohol abusers showed a 67% decrease in number of days intoxicated and a 150%
increase in earned income. Drug abusers showed a 67% decrease in opiate use, 50%
decrease in stimulant use, and a 390% increase in earned income.
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