Mental healthcare more than pays for itself


READER RESPONSE:Investing in mental health services will pay for itself in economic terms within two years, writes Dr Brendan Kelly 

I AM writing further to various articles in HEALTHplus regarding budgetary prospects for 2009.

Clearly, the tasks of improving public finances and rebuilding the economy require a sophisticated approach to public spending.

Simple cuts, however, conceived in haste, will produce neither a short-term stimulus nor long-term returns.

Targeted spending, with clear evidence for long-term returns, should form the mainstay of policy at this difficult time.

The mental health service is one area that richly merits investment.

The cost of mental health problems in Ireland was more than €3 billion in 2006, of which more than €2 billion was attributed to lost output, owing to non-employment, under-employment, premature mortality and unpaid work (according to Eamon O'Shea and Brendan Kennelly, Irish Centre for Social Gerontology, NUIG Department of Economics, Mental Health Commission).

These costs are in addition to the unquantifiable psychological, emotional and human costs experienced by individuals with mental illness and their families.

There is plentiful evidence that various psychological, pharmacological and social treatments alleviate many of the symptoms of mental illness. Such treatments make sense in economic terms too.

Author Richard Layard in the British Medical Journal(BMJ) has noted that a course of evidence-based psychological therapy for anxiety or depression costs £750 (€874) per person, results in significant improvements in symptoms, and, over the two years following therapy, results in increased time in work and increased economic output to the value of £1,880 (€2,190) per person (BMJ 2006; 332: 1030-2). In other words, mental healthcare more than pays for itself in economic terms, as well as, most importantly, reducing the suffering of individuals with mental illness and their families.

Regrettably, the proportion of Ireland's healthcare budget devoted to mental healthcare is falling precipitously, from just under 14 per cent in 1984 to 7.76 per cent in 2007.

Given the deterioration in our public finances, it may well be important that the Government spends less, but it is even more important that the Government spends wisely. Investing in mental health services will help relieve psychological suffering, reverse existing service deficits, provide a modest fiscal stimulus, and, within two years, more than pay for itself in economic terms.

Every which way you look at it, investing in mental health makes sense, now more than ever.

Yours, etc,

Dr Brendan Kelly

Senior lecturer in psychiatry

University College Dublin

Mater Misericordiae University Hospital

Dublin 7