What We Can't Forget When We Talk About the 'Cost' of Mental Illness
We’re beginning to talk more about the cost of mental illness as a way to propel the conversation forward due to the large economic costs to our society.
When we talk about it, we talk in terms of lost labor hours and wages, or the cost to our health system. We talk in macro-economic terms because the problem is of such great magnitude that it actually can impact our economy. If you Google what mental health costs in Canada, you’ll learn that it costs our economy over $50 billion every year. You’ll learn that the cost of mental illness represents almost 3% of our nation’s GDP.
It’s estimated that 6.7 million Canadians are struggling with their mental health, vs 2.2 million dealing with diabetes and 1.4 million with heart disease (CMHA). Despite mental illness affecting 20% of the population, only 7% of our health care budget is spent on mental health.
But, I’d like to focus on the micro-economic costs of mental illness — the costs we don’t talk about that impact how well or how poorly we can line our pockets. Because I’m angry about it. This post is not a happy one, but it’s a necessary one.
We know the numbers on the national impact of mental illness, but what about on an individual basis? How expensive is it?
We need to discuss these concerns, because it’s important we acknowledge that accessing mental health care in our country is reserved for the privileged. Our public health care system is inadequate, underfunded and overburdened, leaving those struggling to seek out private care options. Canada boasts being a country with public health care, but the mental health side is largely privatized. This points out one flagrant fact: our health care system does not see mental health and physical health as equally important. As a result, far fewer resources are allocated to mental health care and the ratio of needs to resources is grossly disproportionate.
Beyond that, the public health care system only provides support in a couple of very small areas — emergency intervention (hospitalizations) or prescribing pharmacological support (like antidepressants). A note about pharmacological support — you don’t have to pay for the doctor to prescribe it, but in order to not pay for the pills themselves, you have to have fantastic extended health insurance (so basically private). Personally, these two areas represent less than 10% of my actual mental health care needs. The other 90% is self-funded.
So what does that 90% cost? Well, in the past year alone, I’ve spent almost as much of my money on mental health care as I have on rent. I maxed out my extended health converge from work within the first month.
It costs a ton of money — in fact, therapy alone is close to two times what my annual university tuition was (and I was in one of the most expensive undergrad programs).
In Ontario, the average income is less than $60,000, which is about $45k after tax. From what I’ve seen, the running rate for therapy in Ontario is $225 per hour. So if you’re an average person in Ontario and go to therapy weekly, you’re paying $12,000 a year. More than a quarter of your income is going just to therapy. Considering a good insurance plan for that income bracket is $1,000 a year for mental health, you are covered for just over one month of the year.
The cost of mental health goes beyond therapy, however. There are costs I incur for physiotherapy and massage therapy, because the physical symptoms of mental illness are very real. That’s another couple thousand bucks a year. Since my illnesses are largely “treatment resistant,” meaning most medication doesn’t actually work for me, not to mention I’ve had horrible side effects from pharmacological support, I’ve had to use a naturopath to find more natural remedies and adjust my diet. So tack on another couple grand. When I do take prescription medication, it can cost hundreds of dollars a month. I remember being in university and being apprehensive about trying a new medication because there was no generic version, so it would cost me $400 a month. This past year I tried a new medication, and a trial of just six pills cost $45. Part of me was relieved when it didn’t work because I didn’t know how I would afford it otherwise.
Even without doing a bunch of math, it’s clear that having a mental illness is expensive. In fact, it’s basically unaffordable. And you might be thinking that there are some free programs available to people who really need it, and you’d be right. The issue is that those services are largely inaccessible due to them being over-burdened. Wait times are staggering and it can take over a year just to get an assessment for what programming you’d be eligible for. Then you wait again for a spot to open up in that program. When you’re struggling with your mental health, that wait time can quite literally be a death sentence.
When we find out someone is struggling, our first thought is to reassure them that help is available. But do we ever think about if that help is actually accessible? Do we stop to acknowledge the financial barriers that could get in the way of them getting help? When we tell people to get help, do we recognize that because the cost is so high, they may have to make significant life sacrifices? We shouldn’t have to ask these questions. People shouldn’t have to pick between taking care of their mental health or putting food on the table. In a country with universal health care, we shouldn’t have to open our wallets to buy access to services because the free services become basically useless when they’re inaccessible. But we do.
Until we as a society can finally recognize that mental health is just as important as physical health, we will always have to ask these questions. People will have to spend five digits annually out of pocket to take care of their mental health needs. Until we bolster our services enough to reduce the strain on current infrastructure, people will continue to slip through the cracks.
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Getty image via vmargineanu