Gaining an understanding of the magnitude and burden of untreated mental illness eludes most Americans. Mental illness is a subject that many of us do not wish to discuss, yet it has a surprising impact on all of our lives.
One in four families has at least one member with a mental disorder. Many times family members are the primary caregivers and the illness has a dramatic impact on the entire family, their quality of life and their financial circumstances. Mental illnesses are major causes of widespread illness, disability and premature death in the United States. People with an untreated mental disorder can be forced into economic dependence, homelessness, social isolation, unwanted job changes, lost opportunities for promotion and education, unemployment and other disruptions in their life. They can also be victims of human rights violations and discrimination.
On a larger scale, three of the six leading factors that impact our life span are related to disabilities due to psychiatric disorders (depression, schizophrenia and bipolar disorder). On average, people with a diagnosed persistent mental illness will die 25 years earlier than the general population.
In the state of Florida, on average, every three hours a person commits suicide. It is the second-leading cause of death for persons age 25 to 34. In 2009, more Floridians died of suicide than from homicides and HIV combined.
This leads us to ask the question: Why invest in mental-health services? Is there really a return on investment? Most people think the cost of mental illness is in terms of providing treatment. The real cost, however, is related to indirect factors. A recent study estimates that various mental illnesses cost society $255.4 billion annually in lost earnings in the U.S. If you apply that to Florida, that represents $26.1 billion in lost earnings.
So as the Legislature looks once again this year to cut funding to mental-health services, it is important to understand that if mental-health services are not funded directly, these costs show up in other systems, often at much higher rates and for much longer time spans. They get shifted to the child-welfare system, education system, criminal and juvenile justice system and health-care system.
In Florida, mentally ill individuals in jail and prison outnumber those in state mental hospitals by nearly five to one. Nearly 50 percent of persons in state prison with mental illness were incarcerated for nonviolent crime. The cost of repeatedly arresting people with mental illness is staggering. Minimal care for one mentally ill person for one year in a Florida jail costs $40,000, while intensive community mental-health treatment (like the community-based services provided at the David Lawrence Center) for that same individual is less than $20,000.
Mental illnesses do not occur in isolation. People with mental illnesses die much younger than the general population. Often the cause of death is associated with physical and chronic illness such as diabetes, cardiovascular disease, cancers and respiratory disease.
The relationship between physical illness and mental illness is bidirectional: persons with mental illness are more likely to have certain physical illnesses, and persons with chronic physical illnesses are more likely to have mental illnesses such as depression and anxiety. For example, 27 percent of persons with diabetes have major depression. Thirty-three percent of persons with cancer, 31 percent of persons with a stroke, 22 percent of persons with myocardial infarction and 29 percent of persons with hypertension also have major depression.
Untreated or poorly managed psychiatric problems affect health-care resource utilization through increased length of stays in hospitals and repeated access to emergency rooms. The growing body of evidence suggests that psychiatric treatment can reduce outpatient and inpatient medical utilization. Recent studies find that unless the mental illness component is treated, medication adherence is compromised. This results in higher health-care costs and therefore untreated mental illness results in reduced health outcomes and higher costs overall.
When it comes to children, the cost of childhood mental-health disorders can be vast and largely hidden. Early onset of mental-health disorders disrupts education and early careers. The consequences into adulthood can be exponential if effective treatment is not provided.
Cost-effective solutions that ease the burden of untreated mental illness are available for the Collier County community at the David Lawrence Center, which serves as the behavioral health component of our community's health-care network. As a not-for-profit organization founded and still governed by community leaders, David Lawrence Center can only accomplish this through collaborative partnerships that encourage members of our community to embrace and invest in our efforts to ensure the health, well-being and safety of our community.
For more information, call 239-455-8500 or visit www.DavidLawrenceCenter.org.