Am I nuts?



The cost of mental illness

I’m trying to get my head around the statement that one in four people will suffer mental ill health during their lives.

“Rethink” website states…one in four people are (sic) affected by mental illness.

Mental Health Foundation says… one in four people will experience some sort of mental health problem in the course of a year, and one in six at any single time, ie today.

Mind says broadly the same.

What does this mean?

Say there are 50 million people in the UK.

That’s 8 million people in the UK today, and tomorrow, who actually have a mental illness of some sort.

And it means that 12.5 million will suffer mental health problems sometime during their lives.

How long will this illness last? One day? A year? A lifetime?

How long is a period of mental illness?

Here I have a problem. Brief searches unsurprisingly do not tell me how long an episode of mental illness lasts.

Depression can last many years, or a few weeks. A person may be on an anti-depressant for years, without symptoms showing because they are controlled by the medication. Are they depressed still? How long was their episode?

Bipolar can come and go for a lifetime. Schizophrenia patients can be symptom free in six weeks, but half will experience a further episode.

Why do I need to know this?

What I want to know is on any given day, like today, how many people are in need of support during a period of mental illness?

NHS Confederation gives several estimates of the proportions of people with given mental illness conditions who are receiving treatment. A quarter seems to be a median sort of figure.

So today it is likely that 2 million people with mental illness are receiving some sort of treatment.

Is this just medical treatment? Does it include care? Support? In the community.

I wonder how many people develop symptoms each day and therefore might present for diagnosis on any given day? And how many people don’t?

What do we know?

That today there are 6 million people in the UK who have symptoms of a mental illness but are not receiving treatment.

We know that many of these people will live with these symptoms for a long time. Partly because they are untreated, partly because the illness is chronic.

We might infer that if these undiagnosed and untreated people presented at their GP they would swamp GP capacity.

We might infer that if GPs referred a fair proportion of these patients on to specialists, their capacity would also be swamped.
The chief medical officer stated this year that in 2013… “70 million working days lost to mental illness last year and £70 to £100 billion cost to the economy”.

We might therefore also infer that a good proportion of this £100 billion cost to the economy would be saved if a good proportion of the 7.5 million people with mental illness were provided with treatment and support.

The Kings fund in 2008 reported that treatment and care service costs for people with mental illness in 2007 was £22.5bn. This was projected to rise to £44bn by 2026.

Now, we have to assume that those patients being treated now are likely to be the most costly, including inpatients stays and highly specialised input. So let’s assume that the cost of treating the other 75% of people with mental illness on any one day is another, ooh, £15bn.

And when you treat these people, who currently receive no treatment and support, many of them will get better. Many will have shorter episodes, will not experience recurrence. So this will reduce the number of people with mental,illness and in need of treatment and support.

Of course there will still be people coming into the system for the first time, as the population moves on. But if these people are being treated early on in their first episode many will need less or no treatment in the future.

So where does this leave us?

Current working days lost cost to the economy of current mental illness estimated at £100bn pa.

Current cost of medical and other treatment for the 25% of people with mental illness who receive treatment, around £25bn.

Additional cost of treating the other 75% around £20bn, which lasts for say five years, total £100bn.

After five years the ongoing cost of treatments, after initial huge increase in diagnosed patients, falls back to current current £25bn plus say £10bn, total £35 bn pa.

Savings to the economy in lost days work, say 75% of current £100bn, equals £75bn. Beginning incrementally in year one and rising to maximum in year six. Total savings over five years £175bn.

Net cost of providing treatment for all people with mental illness…

A grand saving per annum, in the first five years, of £75bn.

And thereafter, per annum savings of £65bn.

That seems a worthwhile investment!

Not to mention 6 million less people walking around without mental illness black dogging their lives.


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