In the previous issue of Invested, we explored the economic impact that the lack of mental health care has in Canada and around the world. In this issue, we look at examples of external forces that affect a person’s mental health and how funding sectors outside of health care can decrease the overall economic burden.

In the previous article, the economic costs or burden that lay on industries outside the health care sector were described as “indirect costs.” Fields such as schools, businesses, social services, housing, criminal justice departments, and community developments all share in aiding people with mental illnesses. This is because everything, from a person’s socioeconomic status and level of education to their sexual orientation and ethnic background, influences a person’s state of mental health and wellbeing. (Taylor, 2018)

Being at a disadvantage economically leads to greater exposure to risk factors associated with mental illness, such as social exclusion or unsafe social connections, chronic stress, and potentially higher levels of exposure to environmental pollutants. On the other side of the coin, this high-risk population typically has poorer access to protective factors such as education, safe meaningful social connections, and well-maintained living conditions. (Knapp & Wong, 2020) This TED Talk goes into greater detail of how economic inequality impacts society.

When looking through a cultural lens, racial and ethnic minorities in North America are more likely to underutilize available mental health services, prematurely discontinue treatments, and receive care that is lower in quality compared to their white counterparts. This is the case even after differences in socioeconomic status between cultural groups have been adjusted for. (Cabassa & Baumann, 2013)

Nipping the problem in the bud and decreasing a person’s risk factors through allocating available resources to social programs and community interventions that consider each demographic's unique needs and circumstances would then be the most effective way to keep costs down overall. (Cabassa & Baumann, 2013) Programs aimed at mental health in both a clinical setting and in the community can be adapted to a patient's background by integrating meaningful factors. This can include having the caregiver be a part of the participant's social sphere, using the participant's native language when possible, and teaching caregivers about biases to ensure the space is free of judgment. This increases the relevance, acceptability, efficacy, and sustainability of treatments. (Cabassa & Baumann, 2013)

The goal of economic analysis in the mental health sphere is to bring these other sectors and their indirect costs to the forefront, allowing government leaders and policy makers to view mental health expenditure with a wider societal lens when allocating available resources. This elimination of any potential “silo budgeting,” or when sector budgets are created separately resulting in a “disincentive to choose the most efficient course of action” (Knapp & Wong, 2020), would ensure that the biggest positive impact could be made.

In following issues of Invested, we will look into the limitations of mental health economics and what the ROI looks like for Canadian mental health initiatives. 

Biobliography

Cabassa, L. J., & Baumann, A. A. (2013). A two-way street: Bridging implementation science and cultural adaptations of mental health treatments. Implementation Science, 8, 1-14. 

Knapp, M., & Wong, G. (2020). Economics and mental health: the current scenario. World Psychiatry, 19(1), 3-14. Taylor, H. G. P. (2018). Helping to Improve the Mental Health of Canadians. Canadian Journal of Community Mental Health, 36(Special Issue), i-iv.