The costs of not dealing with mental health… the benefits of dealing with it…

 

George Lucki

WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011

The World Economic Forum based in Geneva, Switzerland typically concerns itself with macroenomic concerns related to gobal competitiveness, global risks, the future of financial institutions and similar issues. The forum also considers the economic dimensions of more directly social issues such as pensions or healthcare.

Recently the World Economic Forum released a report considering the Global Economic Burden of Non-Communicable Diseases.  Mental illnesses are not communicable diseases…  and their economic impact is staggering!

The evidence gathered is compelling. Over the next 20 years, NCDs will cost more than US$ 30 trillion, representing 48% of global GDP in 2010, and pushing millions of people below the poverty line. Mental health conditions alone will account for the loss of an additional US$16.1 trillion over this time span, with dramatic impact on productivity and quality of life.

By contrast, mounting evidence highlights how millions of deaths can be averted and economic losses reduced by billions of dollars if added focus is put on prevention. A recent World Health Organization report underlines that population-based measures for reducing tobacco and harmful alcohol use, as well as unhealthy diet and physical inactivity, are estimated to cost US$ 2 billion per year for all low- and middle-income countries, which in fact translates to less than US$ 0.40 per person.

Wow! Dealing with tobacco, harmful alcohol use, and unhealthy diet all for far less than the cost of a daily cup of coffee… or a very tiny fraction of the cost of a consultation with your local physician or psychologist for that matter. Dealing with health care concerns of any sort is a huge undertaking compared with the potential benefits of prevention.

Mental health concerns alone account for over half of the global burden of all non-communicable diseases. What is $16.1 trillion? A staggeringly large amount of money. $16,100,000,000,000.00 – to put it in some perspective global health care spending is now just over $5 trillion. Spending on mental health of course is a small fraction of this…

Now if we were to put the economic loss in human terms. This year alone almost 1,000,000 people will have commited suicide across the world and over 150 million people suffered from depression. Approximately 200 million person-years of healthy life were lost to disabling mental health conditions – that is 200 million people last year were disabled, unable to work, severely impacted in relationships, lifestyle and health because of a mental health concern. What is even more relevant is that most of these conditions are curable or at least treatable.

WHO estimates that 25% of all patients using a health service suffer from at least one mental, neurological or behavioral disorder, most of which are undiagnosed or untreated. Further, there is a two-way relationship between mental illnesses and other chronic conditions: the existence of a different chronic condition (as well as HIV/AIDS) exacerbates the risk of developing a mental disorder, and vice versa. In addition to the lack of diagnosis and systematic mental health plans, mental illness suffers from societal stigma, constituting an immense barrier to treatment and access to services.

It seems pretty clear that we’re not tackling the problem effectively… and yet the problem is costly one for societies. The estimated impact of mental health conditions on lost productivity is estimated to be approximately 5% of global GDP! The impact of mental illnesses on lost economic output is greater than that of cardiovascular diseases, approximately twice that of cancer and many times greater than diabetes. Food for thought… treatable conditions, preventable human suffering, significant human and economic benefits addressing the problem – it seems so straightforward that you’d have to “be crazy” not to take urgent and comprehensive action.

Whether the decision makers focus on the direct human burden of suffering or the dollars lost in economic productivity – the numbers are there and are an urgent call to action. The solutions are also clear. In mental health it is an investment in the better management of chronic conditions, the early identification and prompt treatment of treatable conditions and the reduction of social stigma The last of these is particularly important. Depression, for example, is a treatable condition for which there are quite effective psychotherapeutic and pharmacological approaches. Estimates suggest that less than half of individuals who experience clinically significant depression seek help. Stigma and awareness, along with difficulties in access are the reasons.

So, let’s all take steps to raise awareness and advocate for what makes sense, and urge political, health and business leaders to take urgently needed action.

 

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