ECON 440 Lecture Notes - Lecture 24: Bipolar Disorder, Cognitive Disorder, Asperger Syndrome
13 Jun 2018
School
Department
Course
Professor
Defining characteristics of mental illness and treatment
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Organization of mental health services and insurance coverage
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Health economics in mental health
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Policy reforms and questions
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Outline
Prevalent
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Variable
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People with mental illnesses are dangerous
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Mental illness cause by alcohol/substance abuse
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Stigmatized
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Patients, community, and society bear costs
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Expensive
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Mental illness
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Can be very effective
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Medical and social services
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Medication + behavioral therapies
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Is multifaceted
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Has undergone significant changes (also delivery structure)
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Some have little to no costs, others have incredibly high ones
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Very skewed expenditure distribution
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Treatment for mental illness
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Defining Characteristics
Onset often occurs in teens or early 20s
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One in five people has a diagnosable mental disorder during the course of a year
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Symptoms may wax and wane over time
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Recovery without medical intervention is possible
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Approximately 15% of all adults who have a mental disorder in one year also experiences a co-occurring
substance (alcohol or other drug) use disorder, which complicates treatment
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Along with cardiovascular disease + cancer
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Mental illness is high-up in decreasing disability-adjusted-life-year measurement (DALY)
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Mental Illness if Prevalent
Phobias, panic attacks, generalized anxiety, OCD, and PTSD
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Inappropriate anxiety
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Psychosis, schizophrenia
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Disturbances of thought and perception
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Depression, mania, bipolar disorder
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Disturbances of mood
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Dementia, attention, and language problems
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Cognitive dysfunction
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Substance abuse
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Eating disorder; Autism, Asperger's
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Other
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Overlapping symptoms and co-occurring disorders
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Types of Mental Illness
Moderate vs Severe Mental Illness
Lecture 24 - The Economics of Mental Health
Wednesday, April 11, 2018
10:02 AM
ECON 440 Page 1
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Severity
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Disability
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Ability to recover/regain function
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Mental illnesses vary in:
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This is true of both mental and physical illnesses
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Signs and symptoms exist on a continuum and there's no "bright line" separating health from illness, distress
from disease
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Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
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Diagnoses of mental disorders made using specific criteria are as reliable as those for general medical
disorders
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This process is to some extent socially constructed, and drug companies, advocacy groups, and health
professionals can and do influence this process (shifts the "bar" around)
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Mental illness is present when a trait (or a combination of traits) reach a sufficiently high level
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Disease cutoffs also change for physical illnesses
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Variability of Mental Illness
Negative association of mental illness --> creates bias against people with mental illness
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Manifested by bias, distrust, stereotyping, fear, embarrassment, anger, and/or avoidance
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Leads others to avoid living, socializing, or working with, renting to, or employing people with mental
disorders, especially severe disorders such as schizophrenia
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Reduces patients' access to resources and opportunities (e.g. housing, jobs) and leads to low self-esteem
and isolation
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This affects how we fund and finance care
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Deters the public from seeking, and wanting to pay for, care
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Can result in outright discrimination and abuse
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Stigma
Spending for treatment and rehabilitation
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7.3% of total health spending
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Direct costs of mental health services in the US in 1996 estimated at $69 billion
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Indirect costs of mental illness were estimated in 1990 at $78.6 billion (lost productivity)
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7.2% of government health expenditures
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Additional private spending
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In Canada, $14.3 billion in public dollars for mental health services and supports in 2007/8
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Income support - 18%
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Education - 5%
Per capita spending on mental health in Canada:
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Direct and Indirect Costs
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