Mental Health: A Nation’s Wealth

As the world becomes increasingly globalized, countries strive to be at the forefront of economic development and growth. Economic growth leads to higher standard of living, improved technologies, new opportunities, and other positive improvements in a country. Therefore, it is important for a country’s policymakers, economists, and analysts to understand factors that affect economic growth. It’s well known that health and economic growth have an interdependent relationship, but recently more focus has been given to specific facets of health, especially mental health. Studies have shown that mental illness has detrimental effects on a nation’s economy. In 2011, the World Economic Forum projected that mental illness will account for more than half of the global economic burden attributable to noncommunicable diseases by 2030 (Knapp & Wong, 2020). The global estimated impact of mental disorders, neurological disorders, and substance abuse between 2011 and 2030 is 16.3 trillion US dollars, exceeding cardiovascular disease, cancer, diabetes, and other more commonly examined health issues (Knapp & Wong, 2020).

Why does mental health affect economic growth?

Lower Productivity within the Workplace

This poses a question: Why does mental illness take such a large toll on the economy?

Mental illness mostly affects labor.  In the workplace, mental illness contributes to presenteeism, which is lost productivity at work when employees aren’t fully functioning (Luyten & Knapp, 2017). Workers with mental illness can be less productive, seen through poor organization, loss of concentration, poor decision making, higher stress levels, and interpersonal relationship issues. Overall, with presenteeism, workers underperform, contributing to lower levels of efficiency. Along with presenteeism, mental illness also contributes to absenteeism, which is the failure to go to work. These absences can be attributed to symptoms of mental illness or indirect effects of mental illness on daily life. Take stress for an example. Though stress itself is not an illness, it is strongly connected to many mental illnesses, such as depression and anxiety. The Chartered Institute of Personnel and Development conducted a survey of human resource professionals, which reported that 49.6% of respondents in the private sector and 76% of respondents in the public sector stated stress was their leading cause of absence (McDaid, 2008). Though presenteeism and absenteeism may seem insignificant, the accumulation of their effects over many workers leads to lower economic output. For example, in the UK, 1% of working hours are lost due to absenteeism. Though presenteeism is harder to measure, surveys based on self-reports estimate an additional 1-2% direct output cost. Combined, these two factors contribute to an output loss of about 7.5% in the UK (Layard, 2013).

Higher Unemployment in the Workforce

Zooming out to look at the workforce, people suffering from mental illness are less likely to be employed. In addition, unemployed mentally ill individuals are more likely to experience long term unemployment (McDaid, 2008). Much of this trend can be attributed to the stigma surrounding mental illness in employment. Many employers believe that employees with mental health difficulties are less reliable than those without. In a survey conducted by the National and Economic Social Forum in Ireland, over ½ of employers believed hiring someone with a mental illness was a considerable risk. In an earlier survey by the National Disability Authority, only 55% of people believed that individuals with a mental illness should have the same employment opportunities as those without (McDaid, 2008). Interestingly, if people with mental illness received treatment to have the same employment rate as the rest of the population, total employment would be 4% higher (Layard, 2017).  In addition, mental illness is linked with premature retirement. In an analysis of labor supply by the National Bureau of Economics, depression increases the probability of premature retirement by 27% (National Bureau of Economics, 2016). This accumulates to many lost employees and hours of work. Therefore, with less productive workers and less people working, an economy wouldn’t be operating at maximum efficiency.

Moving Forward

With mental illness taking such a large toll on the economy, one would expect countries to have a quick call for action. However, this isn’t the case. Currently, there is not enough mental illness prevention, accessible treatment, and efficient policies. Mental health is not a priority in many governments. In most European countries and the US, less than 10% of their health budget is invested into mental health care (McDaid, 2008). In a typical country, 1 in 5 suffer from mental illness, less than half of adults diagnosed with mental illness even receive treatment, and depression is still the leading cause of disability worldwide (Layard, 2017). Mental illness and substance use have the largest treatment gap, which is the difference between the number who need mental health care and those who actually receive it (Trautmann et al., 2016).

Moving forward, countries need to invest more into mental health care. It would also be worthy to frame mental health as a public and community effort. Though the experience of mental illness is highly individual, mental health promotion goes across many different areas and sectors in the community. Therefore, collaboration is needed for forward progress. The government can create policies focused both on mental illness prevention and creating accessible treatment. Within the government, collaboration between government departments, such as labor, housing, health etc. is needed to create a national strategy. The government also plays a leadership role in bringing different areas of policy together, in which the rest of the public can use as a model. In addition, mental health policies need to account for a wide range of disorders, disabilities, and mortality (Jenkins, 2005).

Mental illness prevention and treatment can also involve more specific interventions at a lower level. For example, in Australia, studies were conducted on workplace mental health interventions. Employees were asked to complete a screening questionnaire, which was then followed by care specialized to those found suffering or at risk of developing depression and anxiety. This care involved CBT courses in six sessions over 12 weeks. The study concluded that after treatment, productivity in the workplace rose (Luyten & Knapp, 2017). Though this example was in the workplace, interventions can also be established in other areas, such as schools and community centers. Additionally, not all policies and interventions must focus on mental health to address it. Policies tackling health inequalities, education, employment, income inequality, and climate change can also affect mental health.

What’s being done in the US?

Hopefully, the US will see improvements in mental health promotion and care over the next couple of years. On March 1, 2022, in President Biden’s State of the Union Address, he announced his agenda to address the mental health crisis in the country. It includes strengthening the current system capacity by investing in programs that bring professionals in the behavioral health field, creating new approaches to training a diverse group of professionals, building a certification program for peer specialists, expanding the availability of services, and investing in research. The agenda also includes connecting more Americans to care, such as improving veterans’ same day access to care and integrating mental health treatment into primary care settings. It also includes creating healthy environments, such as implementing mental health care into schools (White House, The White House Briefing Room, 2022).

Though mental health is widely unaddressed and looked over, there is still hope for the future. Just like any other issue, people must push for change. As a community and an individual, we all must work together to create progress for a better future not just for us, but for succeeding generations to come.

Edited by Lola Cleaveland

References

Fact Sheet: President Biden to Announce Strategy to Address Our National Mental Health Crisis,    As Part of Unity Agenda in his First State of the Union. (2022, March 1). The White House Briefing Room. Retrieved April 13, 2022, from https://www.whitehouse.gov/briefing-room/statements-releases/2022/03/01/fact-sheet-president-biden-to-announce-strategy-to-address-our-national-mental-health-crisis-as-part-of-unity-agenda-in-his-first-state-of-the-union/.

Jenkins, R. (2005). Supporting governments to adopt mental health policies. Mental Health Review Journal, 10(1), 33–38. https://doi.org/10.1108/13619322200500008

Knapp, M., & Wong, G. (2020). Economics and mental health: The current scenario. World Psychiatry, 19(1), 3–14. https://doi.org/10.1002/wps.20692

Layard, R. (2013). Mental health. Wellbeing, 1–22. https://doi.org/10.1002/9781118539415.wbwell103

Layard, R. (2017). The economics of mental health. IZA World of Labor. https://doi.org/10.15185/izawol.321

Luyten, J., & Knapp, M. (2017). Economic Evaluation of Mental Health Promotion and Mental Illness Prevention. Global Mental Health, 207–222. https://doi.org/10.1007/978-3-319-59123-0_18

McDaid, D. (2008). In Employment and mental health: Assessing the economic impact and the case for intervention. London; London School of Economics & Political Science

The effect of depression on retirement and Disability Insurance Applications. NBER. (n.d.). Retrieved April 16, 2022, from https://www.nber.org/bah/summer06/effect-depression-retirement-and-disability-insurance-applications

Trautmann, S., Rehm, J., & Wittchen, H. U. (2016). The economic costs of Mental Disorders. EMBO Reports, 17(9), 1245–1249. https://doi.org/10.15252/embr.201642951