Article Abstract

Online ISSN: 1099-176X    Print ISSN: 1091-4358
The Journal of Mental Health Policy and Economics
Volume 18, Issue 3, 2015. Pages: 125-136
Published Online: 1 September 2015

Copyright © 2015 ICMPE.

Time Preferences, Mental Health and Treatment Utilization

Daniel Eisenberg,¹* Benjamin G. Druss²

¹Ph.D., University of Michigan, Dept. of Health Management & Policy, School of Public Health, Ann Arbor, MI, USA
²M.D., M.P.H., Emory University, Rollins School of Public Health, Atlanta, GA, USA

Background: In all countries of the world, fewer than half of people with mental disorders receive treatment. This treatment gap is commonly attributed to factors such as consumers' limited knowledge, negative attitudes, and financial constraints. In the context of other health behaviors, such as diet and exercise, behavioral economists have emphasized time preferences and procrastination as additional barriers. These factors might also be relevant to mental health.

Aims: We examine conceptually and empirically how lack of help-seeking for mental health conditions might be related to time preferences and procrastination.

Methods: Our conceptual discussion explores how the interrelationships between time preferences and mental health treatment utilization could fit into basic microeconomic theory. The empirical analysis uses survey data of student populations from 12 colleges and universities in 2011 (the Healthy Minds Study, N = 8,806). Using standard brief measures of discounting, procrastination, and mental health (depression and anxiety symptoms), we examine the conditional correlations between indicators of present-orientation (discount rate and procrastination) and mental health symptoms.

Results: The conceptual discussion reveals a number of potential relationships that would be useful to examine empirically. In the empirical analysis depression is significantly associated with procrastination and discounting. Treatment utilization is significantly associated with procrastination but not discounting.

Discussion: The empirical results are generally consistent with the idea that depression increases present orientation (reduces future orientation), as measured by discounting and procrastination. These analyses have notable limitations that will require further examination in future research: the measures are simple and brief, and the estimates may be biased from true causal effects because of omitted variables and reverse causality. There are several possibilities for future research, including: (i) observational, longitudinal studies with detailed data on mental health, time preferences, and help-seeking; (ii) experimental studies that examine immediate or short-term responses and connections between these variables; (iii) randomized trials of mental health therapies that include outcome measures of time preferences and procrastination; and, (iv) intervention studies that test strategies to influence help-seeking by addressing time preferences and present orientation.