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Online ISSN: 1099-176X    Print ISSN: 1091-4358
The Journal of Mental Health Policy and Economics
Volume 9, Issue 1, 2006. Pages: 3-13

Published Online: 23 March 2006

Copyright © 2006 ICMPE.


 

An International Review of the National Cost Estimates of Mental Illness, 1990-2003

Teh-wei Hu*

Ph.D., Professor in GraduateSchool, Professor Emeritus of Health Economics, University of California, Berkeley, CA, USA

* Correspondence to: Teh-wei Hu, 412 Warren Hall, University of California, Berkeley, CA94720, USA
Tel.: 1+510-643 6298
Fax: 1+510-643 6981
E-mail: thu@berkeley.edu

Source of Funding: Department of Mental Health and Substance Abuse, the World Health Organization, Geneva, Switzerland.

Abstract

Mental illness is a major group of disorders that can lead to both physical and emotional disability. Policymakers need to be aware of not only the epidemiological indicators of mental illness, but also the magnitude of its negative economic impact. This study reviews international publications on the cost of major mental illness literature from 1990 to 2003. Most of the published studies are conducted in the US and UK. It was found that the negative economic consequences (loss of productivity due to mobility and mortality) far exceeded the direct costs of treatment. The reviewed studies indicate great variations in cost estimates even for the same mental disorder during the same time period within a country. Given the limitations of cost estimation methodology, one should be careful interpreting these cost estimates.

 

Background: Mental illness is a major group of disorder that can lead to both physical and emotional disability. Policymakers need to learn not only the epidemiological indicators of mental illness, such as prevalence rate and incidence rate, but also the size of its negative impact on the economy.

Aims of the Study: This study is to review international publications on cost of major mental illness literature, from 1990 to 2003, focusing on the concepts, methods, and future perspective of cost illness studies. Reviewing the status quo on costs of mental illness can provide further information about gaps, limitations, and future needs on this topic.

Method: This review searched all major international journals in psychiatry, clinical psychology, health economics, and mental health policy published since 1990. All national or aggregate cost of mental illness studies were included in the review. All were individually reviewed using a conceptual framework of cost of illness methodology.

Results: A large majority of published cost of mental illness studies were conducted in the US and UK. Cost of illness studies were lacking from Africa, Asia, Eastern Europe, and Latin America. Empirical results from the reviewed studies indicate that the negative economic consequences of mental illness far exceed the direct costs of treatment, thus making it important to treat mental illness. Direct treatment costs for each mental disorder (i.e. depression, schizophrenia, dementia, etc.) is between 1% and 2% of total national health care costs.

Discussion: The studies reviewed indicate great variation in cost estimates even for the same mental disorder during the same time period within a country. These wide variations may be due to differences in disorder classification, definition of cost categories, sample populations, data sources, and discounting rate. Given the limitations of the cost of illness studies reviewed, one should be careful in interpreting and using these estimated results.

Implications for Health Services: These cost studies can be useful for understanding the magnitude of treating an illness of economic consequences or economic consequences of an illness for purposes of planning or budgeting. Such studies are one way to inform policymakers about economic consequences of mental illness.

 


Received 6 July 2005; accepted 23 February 2006

Copyright 2006 ICMPE