Mental Health Investment: The Economic Case

The link between mental health and economic productivity is well established.

The World Health Organization released the first-ever comprehensive study in April 2016, which estimated the health and economic benefits of investing in the treatment of the most common forms of mental illnesses.

The study took the example of two mental disorders, namely depression and anxiety, which cost the world nearly $1 trillion annually.

“Twenty-three percent of Iranian people of ages 15 to 64 years are affected by one of the forms of mental disorders and illnesses,” the secretary of 34th Annual Congress of Iranian Psychiatric Association, Dr. Arash Mirabzadeh, said in the runup to the event scheduled for October 17-20 at Tehran’s Milad Hospital.

According to Mirabzadeh, as many as 13.5% of Iranians suffer from depression, which is one of the most prevalent mental health problems in Iran, followed by anxiety and personality disorders.

Depression is associated with lower work functioning, including absence, impaired productivity and reduced job retention. In fact, mental disorders and illnesses have a major economic impact due to treatment costs and lost productivity.

 Underinvestment in Mental Health

Good mental health, an essential component of overall health and well-being, is often overlooked in both the community and the workplace, even though the statistics are staggering.

Between 1990 and 2013, the number of people suffering from depression and/or anxiety increased by nearly 50%, from 416 million to 615 million. Close to 10% of the world’s population are affected by mental disorders.

Iran is not an exception, rather the prevalence of mental disorders is relatively higher among Iranians than in other countries.

“Investment in health and mental health in particular is significantly low in Iran and developing countries. Both individuals and families place more importance on other so-called necessities of life, including clothing, cars and restaurants, than their emotional, psychological and social well-being, and unfortunately the delay in seeking treatment and perceiving the need for treatment worsens their condition and leads to costlier and lengthier treatment,” research deputy of Psychology and Behavioral Sciences Faculty at Tehran’s Allameh Tabatabaiei University, Dr. Faramarz Sohrabi, told Financial Tribune.

Asked about the financial burden of mental disorders and illnesses on the economy, Sohrabi, who is also a clinical psychologist, said unfortunately there are no new data in this regard.

Available statistics date back to March 2007-8 when the costs of psychiatric hospitalization of 33,000 people affected by chronic mental illnesses stood at 340 billion rials ($8.71 million).

Referring to the monthly costs of people covered by State Welfare Organization of Iran, which averages at 600,000 rials ($15.3) per patient, he said, “Per capita expenditure on health services are very low. The organization pays as little as 360,000 rials (about $9) per month to households who have one member with serious mental illness. So far, some 56,000 patients with chronic mental illnesses have been identified in the country, of whom only 33,000 are covered by State Welfare Organization of Iran.”

State Welfare Organization of Iran was founded in 1980 with the aim of providing services to the disabled.

Noting that one of the indices of mental health is the number of beds for extending psychiatric services, Sohrabi said, “Shortage of beds–currently at around 10,000–for mentally ill persons is one of the big issues of the healthcare system in Iran. A report by the head of Iranian Psychiatric Association [Dr. Ahmad Jalili] once put mental health expenditure per capita in Iran at below $1.”

Psychotherapeutic measures produce good results provided they are initiated at the right time and the treatment is offered by a competent therapist.

According to the clinical psychologist, Iranian public perception of the effectiveness of psychotherapy and counseling have improved over the last few years, thanks to the rise in social and humanitarian disciplines, particularly psychology at the Master’s and PhD levels and the establishment of Iran’s Psychology and Counseling Organization [in 2004].

“Cultured people, and I don’t mean only those having university degrees, who are concerned about leading a healthy personal and family life, direct more attention on their mental health, no matter how rich they are. There are people who seek counseling, although they don’t have a significant issue when it comes to improving the quality of their lives and their compatibility with their spouses, children and other members of the society,” he said.

On state financial support to psychology clinics, Sohrabi said Iran National Tax Administration regards these clinics as cultural centers that are, according to law, tax exempt.

“People would be more willing to seek professional help if the government backed health insurance companies to provide better coverage for mental health disorders,” he said.

 Modest Fees

Asked about the difference between psychologists’ fees in Iran and other countries, the university professor said Iran’s Psychology and Counseling Organization sets clinical fees every year based on a psychologist’s degree and experience.

“They are lower than what therapists charge in other countries and even lower than what other paramedic services charge in Iran. A standard appointment with doctors and psychologists should take 45 minutes, but Iranian physicians happen to see five patients in this period of time,” he said.

Calling on policymakers in the health sector to invest in the mental health of the society and take measures to prevent mental illnesses, Sohrabi said prevention policies will first reduce the suffering of individuals and then the treatment costs imposed on households, insurances and government.

With preventive programs in place, mentally healthy children can take fuller advantage of learning opportunities, individuals can be more efficient in their job performance and young people can feel safer in the community.

Overall, investing in mental health promotion and prevention of mental conditions is critical to improving health outcomes for individuals, communities and the nation as a whole.