Investing more in treatments for anxiety and depression could save countries around the world billions of dollars, according to a new study.
This is not meant to downplay the toll that mental illnesses take on people and their families. However some experts see this approach as a way to spur governments to open their eyes to a long-neglected health issue.
“This is an argument that we’re hoping governments who have limited dollars will actually respond to because mental health services have not been scaled up in most places,” Judith Bass, Ph.D., a global mental health researcher from Johns Hopkins Bloomberg School of Public Health, who was not affiliated with the new study, told Healthline.
Billions in Returns
The new study, published online this month in The Lancet Psychiatry, estimated the cost of treatment for anxiety and depression in 36 countries representing 80 percent of the world’s population.
The cost of treatment from 2016 to 2030, mainly for psychosocial counseling and antidepressant medications, is expected to be $147 billion.
The savings during that time, though, far outweighs the cost.
Researchers calculated that increasing treatment for just anxiety and depression could result in extra years of healthy living for millions of people at a total value of almost $310 billion.
In addition, improved mental health could lead to greater productivity in the workplace that could result in another $399 billion in returns.
While the paper focused on the economic benefits of treating anxiety and depression, these are not the only illnesses where there is room for progress.
“We have to remember that mental health is the full spectrum,” said Bass, “and that mental health services have to include people with common mental health problems, as well as all the way through psychosis and psychiatric disorders.”
Tackling Mental Health Stigma
This is not the only study to find that focusing on mental illness makes both medical and economic sense.
A report this year by the RAND Corporation estimated that for every dollar spent on a social marketing campaign to reduce stigma about mental illness, California’s economy could gain $1,251. At the same time, the state government could see a return of $36 for each dollar spent.
This is based on the number of people likely to seek treatment for mental illness after being exposed to the “New State of Mind: Ending the Stigma of Mental Illness” campaign.
This projected boost to the economy is largely through increased employment and at-work productivity after people get the help they need.
Another study, published earlier this year in Health Affairs, found that the healthcare costs for patients with severe mental illness outpaced spending for other high-cost patients with chronic illnesses such as heart and lung disease.
One reason is that people can have a mental illness for 10 years or more before being diagnosed, and possibly hospitalized or jailed due to a mental health crisis.
“That’s 10 years during which we could have intervened more effectively in [more inexpensive] ways within the healthcare delivery system to move them toward recovery and change the direction of their lives,” Paul Gionfriddo, president and chief executive officer at Mental Health America, said in an interview with Healthline.
Early Screening to Reduce Costs
Getting people the help they need sooner can reduce the costs in the long run.
Screening tools like the ones found on the Mental Health America website can aid in early diagnosis.
“For early identification the most important thing we can do is to screen ubiquitously,” said Gionfriddo. “Just as we get screened as adults for blood pressure every single time we go to the doctor’s office, so too should we be doing mental health screening.”
The United States also has a “parity” law that requires mental illnesses to be covered by health insurance at the same level as physical health problems.
But even with that, health insurance may not always encourage doctors to screen early and often.
“Certainly the reimbursement system needs to place greater emphasis on providing adequate reimbursement for services that are provided by mental health professionals,” said Gionfriddo.
Scaling Up Treatment
Developing countries face other challenges when addressing mental illnesses.
Chief among these is cost.
With healthcare systems strained by epidemics like Ebola and cholera, governments may have little money in their health budgets for scaling up mental health services.
However, Bass says that research has shown that “low-cost interventions really can be effective.”
Also, existing healthcare systems in developing countries can be adapted to diagnose and treat certain mental illnesses.
“With common mental health problems like depression and anxiety and post-traumatic stress,” said Bass, “there’s a lot of evidence that mental health services can be implemented by nurses, by midwives, and by community health workers who are brought into a system.”
People with more severe mental illness, such as schizophrenia and psychoses, would probably need access to doctors and nurses with more advanced psychiatric training.
Developing countries also face a problem dispelling misconceptions about mental illness treatments, which is common even in countries like the U.S.
“Part of the other side of the equation,” said Bass, “is the socialization of the population that mental health problems are things that can be treated and there are people who can help them.”