Tommy Simoncini

A little has been told about mental diseases and its importance for the well-functioning of the economy. The aim of this article is not to give an exhaustive explanation of how mental disorders happen, neither to talk about how to face them, but to give some figures about them and to make a call to reflection. The health of the people is a matter of importance in its own right, but from an economic point of view the burden of a disease is the labour loss of productivity. When people are not okay will not work okay and as a consequence will be unproductive. However, most of the time when thinking about medical conditions one thinks about physical illness rather than depression, anxiety or bipolarity.

To start understanding the real costs of having people sick, it is convenient to start with a couple of definitions. In health economics two of the main measures to account the burden of diseases are the Disability Adjusted Life Year (DALY) and the Year Lost due to Disability (YLD). The former consists on the number of healthy years lost because of diseases or an early death. The latter is the number of years lived with a disease. According to the World Health Organization (WHO), mental disorders are the leading chronic condition in Europe and the second largest contributor to disability; the unipolar depressive disorder, for instance, accounts for 3% of total DALYs and 11% of YLD; and anxiety disorders accounts for 4% of YLD.

Moreover, a recent WHO study showed that depression and anxiety disorders exceed US$ 1 trillion each year mainly because of unproductivity and absenteeism. Therefore, motivating people to seek help is necessary, even more when considering that returns on investment in treatments outweigh the costs by far: US$ 1 invested leads to a return of $US 4 in better health outcomes and work ability. Despite this, government expenditures on mental health ranged between 1% and 5%, according to the WHO mental health atlas 2011.

An article published in 2004 by Ronald Kessler in the American Medical Association shows that even though severity of the disease was correlated with the probability of getting a treatment in most of the countries, the proportion of serious cases that were not treated went from 35.5% to 50.3% in developed countries and 76.3% to 85.4% in less-developed countries. Hence, this raises the question of why people are not looking for help and how to incentivize treatments.

It is common to talk about a relative that has been diagnosed with cancer or diabetes; but little is told about mental diseases, maybe because of social stigma or because the whole concept is abstract. Notwithstanding, one of the reasons that is certainly relevant is the ignorance regarding these issues and it would be convenient to learn more about them. Sometimes it results difficult to understand why celebrities, that publicly seemed to have everything, took their own life; like the tragic cases of Chester Bennington, Anthony Bourdain or Robin Williams. Even the econometrician Alan Krueger, who was a presidential adviser of Barack Obama and helped to develop modern policy evaluation techniques, joined the list two weeks ago.

As told earlier, the objective of this article is just to review some important concepts and to help understand that mental diseases are as important as physical ones. In the same way one should take care of the flu, a fever or to carry out a good nutrition, taking care of our mind is equally important and we need to keep promoting it. That is probably the reason why the World Health Organization established October 10th to be the World Mental Health Day.