In May, Health Affairs published a study concluding that spending on mental health disorders now outpaces that of all other health conditions. That lands it at the top of the list of "most costly health conditions in the United States," as Psychiatric News puts it in its analysis of the study.
Pooling data from civilian patients (both institutionalized and non-institutionalized) and members of the active-duty military, the study — conducted by healthcare economist and Founding Director of the Altarum Institute's Center for Sustainable Health Spending Charles Roehrig, PhD — concludes that spending on mental health disorders reached $201 billion in 2013.
That significantly outpaces all other condition-specific spending; heart conditions and trauma are responsible for $147 billion and $143 billion in health spending respectively, making them somewhat distant second- and third-place on the list.
Cancer and pulmonary conditions "round out the top five," summarizes HealthLeaders Media. "Next are osteoarthritis, normal birth, diabetes, kidney disease, and hypertension."
Spending on Mental Health Disorders Represents 'a Shift from 1996'
The study shows that, not only has spending on mental health disorders outpaced all other disorders, it has done so for the first time. The findings "represent a shift in spending from 1996, when annual spending on heart conditions was $105 billion compared with $79 billion for mental disorders," the Psychiatric Review article adds.
Why? “A look ahead suggests that reductions in deaths from heart conditions and cerebrovascular disease are likely to drive spending on mental disorders even higher, as more people survive to older ages—when mental disorders, such as dementia, become more prevalent,” Dr. Roehrig wrote.
Dr. Roehrig also noted that these increases in spending on mental health disorders were not necessarily caused by a concurrent rise in costs for this medical specialty. Since 1996, "mental health spending has risen about 5.6% each year, which is right around the average rate for all diseases," per the Psych News report.
On the other hand, costs for other diseases have been lower. Cardiovascular disease, in particular, has been rising by only approximately two percent every year. This is "suggested to be attributable to factors such as improved smoking habits and lower drug costs with the advent of generic statins," again per Psych News.
APA President: 'Need to Invest More in Preventive Care'
More than 40 percent of spending on mental health disorders "is spent on populations in prisons, nursing homes, and other institutional settings," which "demonstrates the need to invest more in preventive care,” APA President Maria Oquendo, M.D., told Psychiatric News.
“While non-institutional mental health care is significantly less expensive, this study should be not misread to mean we need to invest less in mental health care. The reality is that we need to spend wisely.”
"This spending may only be the tip of the mental health iceberg, however," the HealthLeaders Media report points out. "Approximately 1 in 5 adults in the United States — 43.8 million, or 18.5% — experiences mental illness in a given year."
"Only 41% of adults with a mental health condition received mental health services in the past year," the HealthLeaders report continues. "Among adults with a serious mental illness, just 62.9% received mental health services in the past year, reports the National Alliance on Mental Illness."
A recent white paper from Staff Care, entitled “Psychiatry & Mental Health: The Silent Shortage,” found much the same results.
"The lack of emphasis given to the psychiatry shortage is partially rooted in pervasive stigmas about mental illness in the United States," the white paper authors note. "Those suffering from depression and other forms of mental illness frequently are reluctant to discuss their problems, and are often reluctant to seek treatment. While the symptoms of those with heart, lung, orthopedic or other physiological problems typically are readily apparent, the symptoms of those with psychological problems often are not.
"In addition, mental illnesses generally cannot be addressed through medical procedures, but only made manageable through long-term treatment with drugs and/or therapy. Hospitals and clinics tend to be procedure oriented, a 'cleaner' form of medicine where the appropriate surgery/intervention is performed and the next patient is addressed."
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