Untreated Mental Illnesses and its Consequences

Employers could save $4 for every $1 spent by providing more comprehensive mental healthcare coverage, according to a brief issued in September by the National Alliance of Healthcare Purchaser Coalitions. Ensuring proper care for the treatment of mental illness (including, but not limited to stress, anxiety, depression and/or substance abuse) could save employers $225.5 billion a year in lost productivity.

Mental Illness is a Big Problem

Mental health is a major issue in the US, as statistics published in the State of Mental Health in America 2017 reveal:

 

The National Alliance released a report as a companion to its brief. It states that approximately 41% of US adults don’t receive treatment for mental health issues.

Suicide Rates on the Rise

Left unaddressed, untreated mental illness can often result in suicides. From 1999-2006, the total suicide rate increased 28% in the US (National Institute of Mental Health ). In 2016, suicide was the 10th leading cause of death. It was:

  • The 2nd leading cause of death among individuals between the ages of 10 and 34
  • The 4th leading cause of death among individuals between the ages of 35 and 54.

NIMH also states that in addition to the emotional toll, the economic cost of suicide was $50.8 billion in 2013. The amount, which falls most heavily on working age adults, includes medical costs and work-loss results.

The Cost of Mental Illness

Mental illness and physical health go hand in hand. Costs for treating patients with comorbid mental illness can be two to 2-3 times higher than for patients without the comorbid conditions (Journal of Occupational and Environmental Medicine). For example, there is a high prevalence of depression for patients with asthma (45%) and diabetes (27%).

Read colleague Brandon Conroy’s blog, Employers Focus on Mental Health to Improve Bottom Line, to learn more.

The Journal study also found that:

  • Individuals who are depressed are 2 times more likely to develop coronary artery disease or stroke.
    • They are more than 4 times as likely to die within 6 months from a heart attack.
  • There is a strong link between depression and obesity:
    • People with depression had a 58% greater risk of becoming obese than people not suffering from depression.
    • Obese individuals had a 55% increased risk of being depressed than non-obese individuals.

Opioid Addiction and Mental Health

Fair Health reported that private insurers spent $721 million to treat opioid addition in 2015, a 1000% increase since 2010. Experts aren’t sure why, but opioid use and depression are related—suffering from one increases the risk of the other occurring.

There are more than 14,000 specialty addiction treatment programs in the US, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). There aren’t nationally recognized standards for substance abuse treatment, so programs can vary widely in their costs and effectiveness.

In my previous blog, Employers Paying a Large Portion of Opioid Crisis Costs, I discussed the importance of ensuring you’re paying for quality substance abuse treatment programs for your members. Monitoring these programs becomes even more critical when you factor in the detrimental effects that disreputable treatment centers can have on patients who are also suffering from mental illness in addition to substance abuse.

In another blog, Opioid Alternative to Treat Pain Could Increase Costs and Health Risks, I wrote about the use of a controversial treatment being used to treat back and neck pain. Many experts have stated that the treatment, injecting anti-inflammatory drugs close to the spine, is not only ineffective, it could be a major health risk.

  • For your members who don’t get relief from their chronic pain, their mental illnesses could worsen.
  • Mental illness could present in members who did not have it before as a result of their untreated pain.

 

 

What Can Employers Do?

The National Alliance brief outlines 4 steps that employers can take to achieve the 4:1 return on investment employers will get by addressing mental health in the workplace:

 

These 4 steps are very sound and will go a long way to ensuring your members with mental health issues receive the care they need, which in turn will improve retention and productivity. But step 1 may not be easy. Whereas HIPAA allows employers and plan sponsors to use PHI data for treatment, payment, and plan operation functions, Part 2 of HIPAA and other state regulations disallow for the use of substance abuse and mental health data in the same way without a patient’s consent.

In my next blog, I will address the ramifications of these protections.

Sashi Segu

Sashi Segu

Sashi Segu, Counsel, has participated in cases and provided legal expertise on HIPAA, ERISA, privacy, compliance, and other healthcare-related fields. Sashi left Innovu in March 2019 to pursue other interests.

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