Current Public Investments
Approximately $69 billion is spent as direct costs in diagnosing and treating
mental illness in America. Another $74.9 billion was spent in lost productivity
and disability insurance payments or premature death (USDHHS, 2000).
Despite spending a higher proportion of its gross domestic product on health
care, the United States health system ranked 37th out of 191 countries in
a World Health Organization report. The U.S. rank was attributed, among other
things, to disparities in health among the U.S. population and inefficiencies
in the health system overall. The report states that the U.S. spends about
$21.4 billion per year on 185 publicly funded interventions, which save about
592,000 years of life. But, by reallocating those funds to more cost-effective
programs, the United States could save an additional 638,000 years of life.
The WHO report based its findings on five criteria: overall level of population
health, overall health system responsiveness, distribution of responsiveness
across the population, health disparities within the population, and distribution
of the financial burden within the population (WHO, 2000).
When the cost of all diseases and injuries are added together, mental disorders
account for an estimated 20 percent of the total. Table 7-7 reflects the
disparity in investment that is made in research spending of schizophrenia
compared to other diseases (Biomedical Research, p. 2).
The direct costs of mental illness in Texas by both the private and public
sector are estimated to be nearly $4.8 billion a year. Other indirect costs
of mental illness such as lost employment, reduced productivity, criminal
activity, vehicular accidents and social welfare programs increase the cost
of mental disorders to nearly $11.3 billion annually, so the indirect costs
are approximately $6.5 billion a year.
The question is often asked, "Where does Texas rank in per capita mental
health expenditures?" The Texas Department of Mental Health Mental Retardation
(TDMHMR) states, "Texas ranks 42nd among states (43rd if you include the
District of Columbia) in per resident expenditures for mental health services." TDMHMR
reports "state resources for mental health services are directed at those
most in need. For mental health services and mental retardation services
combined, for FY 1998, approximately 64 percent of the operating budget was
allocated to community services, with about 34 percent allocated to campus-based
services and two percent to infrastructure and indirect administration" (TDMHMR).
