Read part 4 to learn more about the critical role of financial resources, stigmatization and availability of competent mental health care providers.

Mental Health: The Cost

Approximately 20-25% of the population in North America experience some mental health issue each year. That, in itself, is an appreciable number of people. However, mental health problems and illness do not occur in isolation. They occur within the framework of society, work, and relationships with friends and family. This means that those suffering mental health problems and illness aren’t the only ones who are impacted. Mental health problems impact relationships, schools and workplaces, and society. Everyone is impacted. This, of course, makes mental health the concern of everyone. It also means that there mental health problems and illnesses have a cost.

1. Direct and Indirect Impact on the Economy

It is estimated that in 2010, the cost of mental health problems and illness to the world economy was 2.5 trillion dollars. It is further predicted that the financial burden of mental health on the world economy will be $16.1 trillion over the next 20 years. According to the MHCC, mental health issues cost the Canadian economy $50 billion each year. The NIMH reports that these costs to the U.S. economy was $100 billion in 2002. All indications are that these costs will be increasing over the next couple of decades if the status quo is maintained. Human resources account for 80% of these costs.

This financial impact reflects both direct and indirect costs. For example, it is estimated that $6 billion of annual costs to the Canadian economy are indirect, whereas the NIMH reports that in 2002 serious mental illness produced additional indirect costs of $193.2 billion for lost earnings and $24.3 billion in disability benefits.

Direct costs of mental health problems and illnesses result from hospitalization and other residential costs, professional care, drugs, insurance, and community-based mental health organizations. Indirect costs include impacts upon business in the form of disability benefits and lost productivity e.g. absenteeism, presenteeism, and turnover, legal/law costs e.g. court costs and incarceration, drain on educational systems, and loss of family revenue as a result of assuming caregiver responsibilities for a family member. There are other indirect costs that don’t lend themselves readily to being measured in dollars and cents. These intangible costs address quality of life and are important to the individual with a mental health problem or illness, as well as to those around the individual.

2. Intangible Costs
3. Impact on Workplace Culture and Productivity

Untreated mental health problems and illnesses can result in loss of productivity for the individual. Because of the potential to negatively impact the workplace culture e.g. lowering morale or introducing dysfunctional coping behaviors, there can be a loss of production seen in coworkers as well.

Although serious mental illnesses have the potential to produce considerable harm in the workplace, these mental health concerns are likely to receive appropriate treatment if the individual is to maintain their employment. Mental health issues that may be overlooked and can negatively impact the workplace include anxiety or other factors associated with mental health problems e.g. feelings of stress or helplessness. Given that 36% of Canadians report experiencing stress and 23% report feelings of worthlessness or helplessness, these “part of life” psychological experiences can impact a large portion of the work force.

Mental health problems in the workplace can either arise from various dysfunctional behaviors or be the cause of those behaviors. For example, workplace bullying is relatively common and can have a negative impact upon the workplace culture. Although bullying may be seen at first glance as a voluntary behavior, it is often a result of challenges in an individual’s personal life e.g. problems in their marriage or other relationships, feelings of low self-esteem or helplessness, or an inability to manage one’s emotional state in a constructive manner.

Businesses and the resultant employment are generally viewed through fiscal glasses. As a result, the financial costs found in lost productivity tend to be the focal point of discussions of mental health problems and illnesses. Fifty years ago, when the primary model describing the employer-employee relationship as a money for-service model, this limited analysis was justified. However, during the latter part of the 20th century, other models have been developed and integrated into the relationship between employer and employee. These other models emphasize intangibles as well as monetary compensation. For example, people may see their place of employment as a place to meet their social needs i.e. the so-called Japanese model. For others, work is a place to develop a sense of achievement and self-esteem by successfully meeting challenges and making goals or being able to contribute to the decision process. Some will seek self-improvement/growth needs through the educational opportunities offered by their workplace. When mental health problems and illnesses are not addressed in the workplace, not only does the bottom line of the business suffer, but so does the ability of coworkers to achieve these intangible needs.

• Impact on Marriage and Other Intimate Relationships

The ability to form and maintain intimate relationships based upon trust is one of the key characteristics that differentiate human beings from other social animals. As a result, intimate relationships play a critical role in human happiness and wellness. Research has demonstrated that intimate relationships, such as marriage, can contribute significantly to our engaging in healthy behaviors or positive coping strategies as a way of dealing with stress and other challenges life throws our way. Fractures in this type of relationship can result in negative ramifications in other aspects of a person’s life.

Mental health problems and illness have the potential to destroy intimate relationships. Perhaps a husband develops schizophrenia. A lack of knowledge about this disorder and its treatment may result in fear and uncertainty in the wife. This fear and uncertainty may, in turn, create distance between her and her husband, perhaps even leading her to leave him. The loss of this social support mechanism may impede the husband’s attempts at recovery.

Alternatively, mental health problems and illnesses may have a more direct impact upon intimate relationships. If one or both individuals have low emotional intelligence, their inability to manage their emotions in a constructive manner may result in fracturing of their relationship as well as negatively impacting other areas of their lives, e.g. work and family.

• Impact Upon Family

For most people, families are the first social group that we belong to. Families are where we learn many of our behaviors for social interactions. If the behaviors that our families display are dysfunctional, there is a high likelihood that, not only will we adopt those behaviors, but we will pass those behaviors down to our children. Mental health problems tend to cluster in families. Although genetics may play a role in the amount of risk a child has in developing psychological and emotional problems, growing up in a family where dysfunctional behaviors are the norm poses challenges to the child developing psychologically healthy.

Outside of intimate relationships, families play a significant role in helping us cope with life and maintaining our health. Mental health problems and illnesses interfere with the ability to benefit from the social support that families can provide. Because mental health issues disrupt familial connections, the feelings of joy and connectedness that family can offer are unavailable.

• Impact on Interpersonal Relationships

People who are clinically depressed can be difficult to be around. It is not a natural state for people to seek out sadness, unhappiness, and feelings of aloneness. Unfortunately, these sorts of feelings are what those who are clinically depressed are immersed in, making it hard for others to want to connect with them.

A major outcome of mental health problems and illnesses is the loss of friendship and the general decline in interpersonal relationships. Whether it is dysfunctional behaviors and cognitions or the embarrassment of the stigma of having a mental health problem or illness, those who have mental or emotional problems tend to lose their connections to others. Alternatively, many who have suffered mental health problems or illnesses since childhood may never have learned how to develop healthy and strong relationships in the first place.

Friendships and other interpersonal relationships are important for psychological, physical, and emotional health. They provide the sense of community that is essential to the well-being of every human being. The isolation that results from the lack of healthy relationships or the destruction of existing ones place us at greater risk for poor physical health and increased risk of psychological, behavioral, and emotional problems.

Stay connected with our next blog to get more information about mental health & strategies for achieving better mental health.