Hidden costs of mental health can hit communities

One thing the pandemic has really highlighted is the importance of mental health. We now know that mental health issues are much more common than previously perceived. Seventeen percent of youth and 20% of adults will deal with a mental health issue this year, says the National Alliance on Mental Illness. It is a complicated issue that comes with a lot of stigma, presenting real barriers to treatment.

Mental health issues do not discriminate, affecting individuals of all economic classes, races, cultures, ages and genders. While it is an equal opportunist in prevalence, there are a great many disparities when it comes to treatment and barriers. Those from marginalized populations and those who are financially stretched, underinsured or uninsured, or low income are affected at an equal rate. But they experience barriers to treatment at a much higher level.

This is especially true of the workplace, which is where many of us spend a great deal of time. Few are comfortable talking about their mental health struggles with employers and colleagues. The result can be a failure to receive early care, leading to loss of productivity or a need for more intensive treatment later. According to the World Health Organization, mental health issues may be responsible for millions of lost workdays each year. This means lost productivity to the tune of $1 trillion globally each year. This trend is increasing, and the burden of mental health issues continues to significantly grow.

Early, appropriate and effective treatment can decrease costs significantly while diverting individuals from hospitals or jails, before the issue becomes a crisis. It is important to know where to go as well as to ensure that services are accessible and affordable. Funding is a large part of what drives the availability of mental health services, especially for marginalized populations and those dealing with financial barriers.

Many states are seeing a crisis in the lack of acute inpatient or crisis stabilization services for those experiencing a psychiatric emergency. Wyoming is experiencing this crisis along with geographic complications (transportation) and economy of scale resources with a frontier population. This contributes to individuals ending up in emergency rooms for care.

In addition to overburdening the hospitals, many individuals that fail to receive treatment end up in the criminal justice system. Serious mental illness is found to be much higher in jails and prisons than can be found in the general population (NAMI). The disparity of individuals with mental illness involved in the criminal justice system has a significant affect on both health care costs and public resources. Appropriate and effective intervention and community-based services can improve outcomes and result in cost savings and reduce recidivism.

NAMI estimates that one-third to one-half of those dealing with mental illness will not seek treatment. Barriers include people thinking they can handle problems themselves, not knowing where to go for help, stigma attached to mental illness and accessibility and affordability of appropriate levels of service. In addition to the financial barrier there is also a time investment needed for treatment that many who are living paycheck to paycheck find difficult to prioritize.

What does this mean for Teton County? The state has an open access system that provides subsidized services for all residents in each county. The funding does not cover the entire cost of service and has decreased substantially over the last 10 years while the demand for services has steadily increased. The town of Jackson, Teton County and local donors have been extremely supportive of mental health. Funding cuts that were put on hold due to ARPA funds are set to hit this next fiscal year. In addition the state is looking at moving from the open access system to one where only prioritized populations have access to the subsidies for care.

The price of not investing in mental health is a burden that we all share. The consequences will fall on the individuals affected, family and caregivers, employers, service providers, government entities and, most importantly, quality of care. The responsibility rests on us all to invest in mental health, both our own as well as our most vulnerable community members.