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Mental illness
causes severe loss of earnings, study says
(August/September
2008 Issue)
By Catherine Robertson Souter
People with mental illness earn less money. That's not exactly
shocking news, of course, but with hard data to show the severe
loss of earning potential faced by those with a DSM-IV serious mental
illness, the argument can be made in courts and policy-making committees
that more is needed in the way of mental health care. In a report
published in the American Journal of Psychiatry in June, researchers
at Harvard Medical School found serious mental illness results in
an average yearly loss of $16,306 in wages for the mentally ill
employee as compared to other comparable employees.
"This study looked at the cost of mental illness from the point
of view of the employee," says Ronald Kessler, Ph.D., lead author
of the study and co-director of the World Health Organization's
World Mental Health surveys.
Based on data from the National Comorbidity Survey Replication
(NCS-R) and commissioned by the National Institutes of Mental Health
(NIMH), the results show a marked difference in the effects of mental
health on earnings between men and women.
The study found that those with serious mental illness in the previous
12 months earned 40% less in that time period. Extrapolated to the
entire U.S. population (estimated at 209 million according to the
2001 census), this would mean a loss of $193.2 billion for those
employees with serious mental illnesses.
The study found that men had a higher loss of earnings than women.
Men made an average of $26,435 less for the 12 months while women
averaged $9,302 less.
"There are two things that we can attribute that to," says Kessler,
who is also a professor of health care policy at Harvard Medical
School. "First, women are more likely to be unemployed because of
mental illness so the impact on men is greater. Women have a more
legitimate role that favors them not being in the work force. As
a female, if you have agoraphobia, you have more choice to stay
in the home."
"In the workplace itself, it seems as though impairments associated
with mental illness lead to lower earnings for men than for women,"
he continues.
The symptoms of the most common mental illnesses, like anxiety
and mood disorders, may affect a man's advancement, he explains.
If a man is not seen as aggressive and confident, he may not get
the corner office and the raise that goes along with it.
The National Comorbidity Survey Replication was initially carried
out in 2001-02, with a national sample of 10,000 respondents. Designed
to examine a wide range of mental health issues, the data was created
to attempt to predict and evaluate the effects of mental illness
on the population. Similar studies are being done in countries around
the world.
Results so far have shown that six percent of mental illness is
severely debilitating and that people can take from six to 23 years
to seek treatment, if they ever seek treatment. The study, using
people from the general population instead of simply those within
treatment facilities, found that nearly 60 percent of those with
active mental disorders had not sought treatment in the prior 12-month
period.
As results from the NCS-R study continue to be teased out of the
data, we learn more about the prevalence of mental illness and the
need for more widespread treatment. As further information is released
from the study of the data set, there is hope that policy can be
changed to meet the needs of the population.
"This information has implications for society as a whole," says
Kessler. "We can look at the consequences of mental disorders, the
cost to employers, to society and to the individual. This helps
to put into perspective some of the policy issues."
This information comes at a time when spiraling costs for mental
health care have pushed employers to view these benefits as a drain
on profits, according to a recent National Public Radio report.
The high cost of antidepressent drugs has been linked to the inflated
prices for health care, the report said, quoting a study in the
journal Health Affairs.
But, Kessler's team has also looked at the issue from the side
of the employer, showing that the cost to the employer of not treating
mental illness was higher than the insurance costs after initial
set-up of the plan.
And, in Massachusetts, a recent report by the Department of Public
Health showed that mental health coverage would add only 0.1 to
0.3 percent to the cost of insurance, according to a Boston Globe
article.
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