Experts Suggest Ways to Deal with Challenges Surrounding Care of Psychiatric Patients

Examining the Economic Burden of Mental Illness: Data Show Rise in Costs

Expenditures for psychiatric conditions are significant as mental disorders continue to rank as the fourth most costly condition in the U.S. According to the Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey (MEPS), U.S. healthcare expenditures related to mental illness totaled $58.6 billion in 2002. In 2012, this figure increased to $83.6 billion.1 (See Figure 2.) Expenditures in MEPS are defined as payments from all sources for such services as hospital inpatient care, ambulatory care provided both in physicians’ offices and hospital outpatient departments, care provided in the emergency department (ED), home health care, and the purchase of prescribed medicines.

Longer hospital stays are one reason costs have increased for patients with mental health disorders, says David M. Grace, MD, SFHM, senior medical officer at the Schumacher Group in Lafayette, La. A 2012 study in the Journal of Emergency Medicine International found that psychiatric patients requiring an inpatient bed at a large academic medical center remained in the ED more than three times longer than non-psychiatric patients, costing the hospital about $100 an hour based on the average hourly revenue per bed.2 The longer non-psychiatric patients wait for treatment, the more likely the hospital is to suffer declines in quality of care, patient satisfaction, and public reputation, the researchers found. By one estimate, spending by general hospitals to care for these patients was expected to rise to $38.5 billion in 2014, up from $20.3 billion in 2003.3

The human cost needs to be factored into these numbers as well, says Ricardo Bianco, PsyD, program director of the Master of Arts in counseling and health psychology at William James College in Newton, Mass. He contends that many individuals have ended up in prison because of an undiagnosed and untreated mental illness. “The news has been filled with such examples lately,” he says. “Such behaviors, consequently, are causing further mental health issues in the victims, survivors, and society in general.”

References

1. Soni A. Medical Expenditure Panel Survey. Statistical Brief #470: Trends in the five most costly conditions among the U.S. civilian noninstitutionalized population, 2002 and 2012. Agency for Healthcare Research and Quality website. Available at: http://meps.ahrq.gov/mepsweb/data_files/publications/st470/stat470.shtml. April 2015. Accessed August 18, 2015.
2. Nicks BA, Manthey DM. The impact of psychiatric patient boarding in emergency departments. Emerg Med Int. 2012;2012:360308. doi: 10.1155/2012/360308.
3. Levit KR, Kassed CA, Coffey RM, et al. Projections of national expenditures for mental health services and substance abuse treatment, 2004–2014. SAMHSA Publication No. SMA 08-4326. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2008.

Figure 2. Expenditures for the Five Most Costly Conditions, 2002 and 2012

Source: AHRQ, Medical Expenditure Panel Survey