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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE (Open Access)

A review of the economic impact of mental illness

Christopher M. Doran A B and Irina Kinchin A
+ Author Affiliations
- Author Affiliations

A Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Sciences, Central Queensland University, Level 4, 160 Ann Street Brisbane Qld 4000, Australia. Email: i.kinchin@cqu.edu.au

B Corresponding author. Email: c.doran@cqu.edu.au

Australian Health Review 43(1) 43-48 https://doi.org/10.1071/AH16115
Submitted: 25 May 2016  Accepted: 1 September 2017   Published: 13 November 2017

Journal Compilation © AHHA 2019 Open Access CC BY-NC-ND

Abstract

Objective To examine the impact and cost associated with mental illness.

Methods A rapid review of the literature from Australia, New Zealand, UK and Canada was undertaken. The review included literature pertaining to the cost-of-illness and impact of mental illness as well as any modelling studies. Included studies were categorised according to impact on education, labour force engagement, earlier retirement or welfare dependency. The well-accepted Drummond 10-point economic appraisal checklist was used to assess the quality of the studies.

Results A total of 45 methodologically diverse studies were included. The studies highlight the significant burden mental illness places on all facets of society, including individuals, families, workplaces and the wider economy. Mental illness results in a greater chance of leaving school early, a lower probability of gaining full-time employment and a reduced quality of life. Research from Canada suggests that the total economic costs associated with mental illness will increase six-fold over the next 30 years with costs likely to exceed A$2.8 trillion (based on 2015 Australian dollars).

Conclusions Mental illness is associated with a high economic burden. Further research is required to develop a better understanding of the trajectory and burden of mental illness so that resources can be directed towards cost-effective interventions.

What is known about the topic? Although mental illness continues to be one of the leading contributors to the burden of disease, there is limited information on the economic impact that mental illness imposes on individuals, families, workplaces and the wider economy.

What does this paper add? This review provides a summary of the economic impact and cost of mental illness. The included literature highlights the significant burden mental illness places on individuals, families, workplaces, society and the economy in general. The review identified several areas for improvement. For example, only limited information is available on the impact of attention deficit hyperactivity disorder, anxiety, cognitive function, conduct disorder, eating disorder and psychological distress. There was also a dearth of evidence on the intangible elements of pain and suffering of people and their families with depressive disorders. More research is required to better understand the full extent of the impact of mental illness and strategies that may be implemented to minimise this harm.

What are the implications for practitioners? Knowing the current and future impact of mental illness highlights the imperative to develop an effective policy response.

Additional keywords: mental health, health economics, health policy.


References

[1]  Department of Health and Ageing. National mental health report 2010: summary of 15 years of reform in Australia’s mental health services under the national mental health strategy 1993–2008. Canberra: Commonwealth of Australia; 2010.

[2]  Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, et al Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380 2197–223.
Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010.Crossref | GoogleScholarGoogle Scholar |

[3]  Australian Institute of Health and Welfare (AIHW). Australian burden of disease study: impact and causes of illness and death in Australia 2011. Canberra: AIHW; 2016.

[4]  Australian Bureau of Statistics (ABS). National survey of mental health and wellbeing: summary of results. ABS Catalogue No. 4326.0. Canberra: ABS; 2008.

[5]  Becker AE, Kleinman A. Mental health and the global agenda. N Engl J Med 2013; 369 66–73.
Mental health and the global agenda.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXhtFygu7zI&md5=082e83cc73fc40baa478f1aabb2126d7CAS |

[6]  Department of Health and Ageing. National mental health report 2013: tracking progress of mental health reform in Australia 1993–2011. Canberra: Commonwealth of Australia; 2013.

[7]  Degney J, Hopkins B, Hosie A, Lim S, Rajendren AV, Vogl G. Counting the cost: the impact of young men’s mental health on the Australian economy. Canberra: Inspire Foundation and Ernst & Young; 2012.

[8]  Hilton M, Scuffham P, Sheridan J, Cleary C, Whiteford HA. Mental ill-health and the differential effect of employee type on absenteeism and presenteeism. J Occup Environ Med 2008; 50 1228–43.
Mental ill-health and the differential effect of employee type on absenteeism and presenteeism.Crossref | GoogleScholarGoogle Scholar |

[9]  Jacobs P, Dewa C, Lesage A, Vasiliadis HM, Escober C, Mulvale G, Yim, R. The cost of mental health and substance abuse services in Canada: a report of the Mental Health Commission of Canada. Alberta: Institute of Health Economics; 2010.

[10]  Doran CM. The evidence on the costs and impacts on the economy and productivity due to mental ill health: an evidence check rapid review brokered by the Sax Institute for the Mental Health Commission of NSW. 2013. Available at: https://www.saxinstitute.org.au/wp-content/uploads/The-evidence-on-the-costs-and-impacts-on-the-economy-and-productivity-due-to-mental-ill-health-a-rapid-review.pdf. [verified 12 October 2017]

[11]  Khangura S, Konnyu K, Cushman R, Grimshaw J, Moher D. Evidence summaries: the evolution of a rapid review approach. Syst Rev 2012; 1 10
Evidence summaries: the evolution of a rapid review approach.Crossref | GoogleScholarGoogle Scholar |

[12]  Australian Institute of Health and Welfare (AIHW). A working guide to international comparisons of health. Canberra: AIHW; 2012.

[13]  Moher D, Liberati A, Tetzlaff J, Altman D, The PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6 e1000097
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.Crossref | GoogleScholarGoogle Scholar |

[14]  Drummond M, Torrance G, O’Brien B, Stoddart GL. Methods for the economic evaluation of health care programmes. New York: Oxford University Press; 2005.

[15]  Mason J, Eccles M, Freemantle N, Drummond M. Incorporating economic analysis in evidence-based guidelines for mental health: the profile approach. J Ment Health Policy Econ 1999; 2 13–9.
Incorporating economic analysis in evidence-based guidelines for mental health: the profile approach.Crossref | GoogleScholarGoogle Scholar |

[16]  Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6 e1000097
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.Crossref | GoogleScholarGoogle Scholar |

[17]  Doran CM. Economic evaluation of interventions to treat opiate dependence: a review of the evidence. Pharmacoeconomics 2008; 26 371–93.
Economic evaluation of interventions to treat opiate dependence: a review of the evidence.Crossref | GoogleScholarGoogle Scholar |

[18]  Leach L, Butterworth P. The effect of early onset common mental disorders on educational attainment in Australia. Psychiatry Res 2012; 199 51–7.
The effect of early onset common mental disorders on educational attainment in Australia.Crossref | GoogleScholarGoogle Scholar |

[19]  Schofield D, Kelly S, Shrestha R, Callander E, Percival R, Passey ME. How depression and other mental health problems can affect future living standards of those out of the labour force. Aging Ment Health 2011; 15 654–62.
How depression and other mental health problems can affect future living standards of those out of the labour force.Crossref | GoogleScholarGoogle Scholar |

[20]  Gibb S, Fergusson D, Horwood L. Burden of psychiatric disorder in young adulthood and life outcomes at age 30. Br J Psychiatry 2010; 197 122–7.
Burden of psychiatric disorder in young adulthood and life outcomes at age 30.Crossref | GoogleScholarGoogle Scholar |

[21]  Laplagne P, Glover M, Shomos A. Effects of health and education on labour force participation. Melbourne: Productivity Commission; 2007.

[22]  Hilton M, Scuffham P, Vecchio N, Whiteford H. Using the interaction of mental health symptoms and treatment status to estimate lost employee productivity. Aust N Z J Psychiatry 2010; 44 151–61.
Using the interaction of mental health symptoms and treatment status to estimate lost employee productivity.Crossref | GoogleScholarGoogle Scholar |

[23]  Stansfeld S, Fuhrer R, Head J. Impact of common mental disorders on sickness absence in an occupational cohort study. Occup Environ Med 2011; 68 408–13.
Impact of common mental disorders on sickness absence in an occupational cohort study.Crossref | GoogleScholarGoogle Scholar |

[24]  Henderson M, Richards M, Stansfeld S, Hotopf M. The association between childhood cognitive ability and adult long-term sickness absence in three British birth cohorts: a cohort study. BMJ Open 2012; 2 e000777
The association between childhood cognitive ability and adult long-term sickness absence in three British birth cohorts: a cohort study.Crossref | GoogleScholarGoogle Scholar |

[25]  Paradise M, Naismith S, Davenport T, Hickie IB, Glozier NS. The impact of gender on early ill-health retirement in people with heart disease and depression. Aust N Z J Psychiatry 2012; 46 249–56.
The impact of gender on early ill-health retirement in people with heart disease and depression.Crossref | GoogleScholarGoogle Scholar |

[26]  Schofield D, Shrestha R, Percival R, Passey M, Callander E, Kelly S. The personal and national costs of mental health conditions: impacts on income, taxes, government support payments due to lost labour force participation. BMC Psychiatry 2011; 11 72
The personal and national costs of mental health conditions: impacts on income, taxes, government support payments due to lost labour force participation.Crossref | GoogleScholarGoogle Scholar |

[27]  Morgan VA, Waterreus A, Jablensky A, Mackinnon A, McGrath JJ, Carr V, Bush R, Castle D, Cohen M, Harvey C, Galletly C, Stain HJ, Neil A, McGorry P, Hocking B, Shah S, Saw S. People living with psychotic illness 2010: report on the second Australian national survey. Canberra: Commonwealth of Australia; 2011. Available at: http://www.health.gov.au/internet/main/publishing.nsf/content/717137a2f9b9fcc2ca257bf0001c118f/$file/psych10.pdf [verified 17 October 2017]

[28]  McCrone P, Dhanasiri S, Patel A, Knapp M, Lawton-Smith S. Paying the price: the cost of mental health care in England to 2026. London: King’s Fund; 2008.

[29]  Smetanin P, Stiff D, Briante C, Adair CE, Ahmad S, Khan M. The life and economic impact of major mental illnesses in Canada: 2011 to 2041. Toronto: RiskAnalytica, on behalf of the Mental Health Commission of Canada; 2011. Available at: https://www.mentalhealthcommission.ca/sites/default/files/MHCC_Report_Base_Case_FINAL_ENG_0_0.pdf [verified 12 October 2017]

[30]  Schlander M. Impact of attention-deficit/hyperactivity disorder (ADHD) on prescription dug spending for children and adolescents: Increasing relevance of health economic evidence. Child Adol Psychiatry Mental Health. 2007; 1 13
Impact of attention-deficit/hyperactivity disorder (ADHD) on prescription dug spending for children and adolescents: Increasing relevance of health economic evidence.Crossref | GoogleScholarGoogle Scholar |

[31]  Scott S, Knapp M, Henderson J, Maughan B. Financial cost of social exclusion: follow up study of antisocial children into adulthood. BMJ 2001; 323 191
Financial cost of social exclusion: follow up study of antisocial children into adulthood.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MvislWgsQ%3D%3D&md5=b64cc389739b2d17cc9330c040673cbdCAS |

[32]  Latimer E. Economic impacts of supported employment for persons with severe mental illness. Can J Psychiatry 2001; 46 496–505.
Economic impacts of supported employment for persons with severe mental illness.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MvosV2gtA%3D%3D&md5=5d540b8e125370f59e889d4402bdbc4cCAS |

[33]  Luppa M, Heinrich S, Angermeyer M, König H, Riedel-Heller S. Cost of illness studies of depression: a systematic review. J Affect Disord 2007; 98 29–43.
Cost of illness studies of depression: a systematic review.Crossref | GoogleScholarGoogle Scholar |