The economic burden of untreated mental illness in Indiana

Abstract

Objective: We sought to estimate the economic burden of untreated mental illness at the societal level. Design, Setting, and Participants: This cross-sectional study used multiple data sources to tabulate the annual cost of untreated mental illness among residents ages 5 and older in Indiana in 2019. Data sources included: 1) the National Survey on Drug Use and Health, 2) the National Survey of Children’s Health, 3) Indiana government sources, and 4) Indiana Medicaid enrollment and claims data. Analysis of these data occurred between January and May of 2022. Main Outcomes and Measures: Outcomes included: 1) direct non-healthcare costs (costs incurred by the criminal justice system and homeless shelters), 2) indirect costs (costs incurred by unemployment, workplace productivity losses through absenteeism and presenteeism, all-cause mortality, suicide, caregivers’ direct healthcare, caregivers’ productivity losses, and missed primary education), and 3) direct healthcare costs (disease-related healthcare expenditures) Results: We estimated the number individuals in Indiana with untreated MI in 2019 to be 429,407 (95% CI: 349,526 to 528,171). The economic burden of untreated mental illness in Indiana was estimated at $4.2 billion annually (Range of uncertainty (RoU): $2.1 billion, $7.0 billion).. The cost of untreated mental illness includes $3.3 billion (RoU: $1.7 billion, $5.3 billion) for indirect costs, $708.5 million (RoU: $335 million, $1.2 billion) for direct healthcare costs, and $116.4 million for non-health care costs. Conclusion and Relevance: In this cross-sectional study, untreated mental illness was found to have significant financial consequences for society. These findings put into perspective the case for action and should be considered by policymakers, clinicians, and employers when allocating societal resources and funding. States can replicate this comprehensive framework as they prioritize key areas for action regarding mental health services and treatments.