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Chartbook on Mental Health and Disability

Section 4: Access, utilization, and cost of services

4.15. How do mental disorders affect the U.S. economy?

The costs of mental disorder and disability due to mental disorder are staggering. An economic estimate of 1990 costs shows almost $150 billion dollars of direct and indirect costs and the estimates certainly would be higher today. The prevalence-based estimate includes direct medical costs of treatment and care, and indirect costs related to loss of productivity due to mental disorder.

Direct costs, obtained from national household interview and provider surveys and agency records, are estimated as the number of health and medical services for mental disorders, and the unit price or charges—a total of $67 billion. Other related direct costs total $2.3 billion and include public and private expenditure for crime ($1.8 billion) and social welfare programs ($515 million) associated with mental disorders.

Costs of reduced or lost productivity total $78.5 billion and include estimates of lost earnings ($59 billion), productivity losses of individuals in mental hospitals or in nursing homes due to mental disorders ($4.1 billion) or incarcerated in prisons as a result of a conviction for a mental disorder-related crime ($573 million), the value of time spent to care for family members with mental disorders ($3.1 billion), and expected value of future earnings or people who have died prematurely in 1990 from mental disorders, including all suicides ($11.8 billion).

Total economic cost of mental disorders in 1990 is almost $150 billion.

Figure 34 (see data table for text-only version)

Figure 34: Estimated economic cost of mental disorders, 1990

Source: Rice & Miller (1998)

Surveys: Services - National Hospital Discharge Survey, National Nursing Home Survey, National Ambulatory Care Survey; Cost of services American Hospital Association, American Medical Association, American Psychological Association, American Council of Social Workers, National Institute of Mental Health, national expenditure data from the Health Care Financing Administration, National Prescription Survey, Department of Justice Uniform Crime report, social welfare expenditures; Income loss - the Epidemiologic Catchment Area study (ECA); Earnings U.S. Census; Caregiver time Massachusetts Alliance for Mentally Ill.

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