|Mental Disorders Cost Society Billions in Unearned
Major mental disorders cost the nation at least $193 billion annually
in lost earnings alone, according to a new study funded by the
National Institutes of Healthís National Institute of Mental Health
(NIMH). The study was published in the May 2008 issue of the American
Journal of Psychiatry.
"Lost earning potential, costs associated with treating coexisting
conditions, Social Security payments, homelessness and incarceration
are just some of the indirect costs associated with mental illnesses
that have been difficult to quantify," said NIMH Director Thomas
R. Insel, M.D. "This study shows us that just one source of these
indirect costs is staggeringly high."
Direct costs associated with mental disorders like medication,
clinic visits, and hospitalization, are relatively easy to quantify,
but they reveal only a small portion of the economic burden these
illnesses place on society. Indirect costs like lost earnings likely
account for enormous expenses, but they are very difficult to define
In the new study, Ronald C. Kessler, Ph.D., of Harvard University,
and colleagues analyzed data from the 2002 National Comorbidity
Survey Replication (NCS-R) [http://www.nimh.nih.gov/health/statistics/ncsr-study/questions-and-answers-about-the-national-comorbidity-survey-replication-ncsr-study.shtml],
a nationally representative study of Americans age 18 to 64.
Using data from 4,982 respondents, the researchers calculated
the amount of earnings lost in the year prior to the survey among
people with serious mental illness (SMI). SMI is a broad category
of illnesses that includes mood and anxiety disorders that have
seriously impaired a personís ability to function for at least
30 days in the year prior to the survey. It also includes cases
of any mental disorder associated with life-threatening suicidal
behaviors or repeated acts of violence.
Eighty-six percent of respondents reported earning income in the
previous year. But those with SMI reported earning significantly
less — around $22,545 — than respondents without SMI,
who averaged $38,852. Although men with SMI took a greater hit
in earnings than women with SMI, men still earned more overall
than women with and without SMI.
By extrapolating these results to the general population, the
researchers calculated that SMI costs society $193.2 billion annually
in lost earnings. The researchers attributed about 75 percent of
this total to the reduced income that people with SMI likely earn,
while 25 percent is attributed to the increased likelihood that
people with SMI would have no earnings.
"The results of this study confirm the belief that mental disorders
contribute to enormous losses of human productivity," said Kessler. "Yet
this estimate is probably conservative because the NCS-R did not
assess people in hospitals or prisons, and included very few participants
with autism, schizophrenia or other chronic illnesses that are
known to greatly affect a personís ability to work. The actual
costs are probably higher that what we have estimated."
The researchers concluded by recommending that future studies
on the effectiveness of treatments should consider measuring employment
status and earnings over the long term to document the effects
of mental disorders on a personís functioning and ability to remain
The National Institute of Mental Health (NIMH) mission is to reduce
the burden of mental and behavioral disorders through research
on mind, brain, and behavior. More information is available at
the NIMH website, http://www.nimh.nih.gov/.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov/.
Kessler, RC, Heeringa S, Lakoma MD, Petukhova M, Rupp AE, Schoenbaum
M, Wang PS, Zaslavsky AM. The individual-level and societal-level
effects of mental disorders on earnings in the United States: Results
from the National Comorbidity Survey Replication. American Journal
of Psychiatry, 2008 May.