Social Consequences of Mental Illness and Access to Treatment
Mental illness is prevalent among adults in the United States, and results in large costs for the afflicted as well as for society as a whole. Moreover, mental illness is often co-morbid to physical health problems, and frequently related to substance abuse. The first two papers in this session document the social cost and consequences of mental illness. Paper #1 uses panel data methods for identification and finds that depression reduces the probability of employment and increases absenteeism. Although the effects are smaller than in prior studies, they suggest depression-induced productivity loss from absenteeism in the U.S. is between 700 million and 1.4 billion per year. Paper #2 uses instrumental variables to identify the impact of treatment for substance use disorders on crime. The estimates indicate that expanding treatment for these disorders by 10 percent would reduce certain crimes by 3 to 5 percent, and result in $1.9 - $3.8 billion in net savings from reduced crime. Despite the productivity and crime-related savings from expanding treatment of mental illness and substance abuse, there are significant barriers to care for many individuals, particular low-income individuals and minorities. Paper #3 investigates disparities in treatment, and highlights the importance of geographic disparities. This paper also considers area-level attributes and policies and determines how they interact with racial/ethnic disparities. The findings will be useful to policymakers in identifying specific area-level policy levers for reducing disparities, particularly in light of the recent decision by some states not to expand their Medicaid programs under the ACA.