Limited mental health equity might cost U.S. $14T by 2040

The United States has a mental health equity problem that could cost it trillions of dollars in the next two decades, according to a new assessment from Deloitte and the Meharry School of Global Health.

The good news? Investing in equitable mental healthcare access, integrated mental health and chronic disease management, and better preventive mental health services could help bend the cost curve.

But if the U.S. continues on its path of limited mental health services, especially for racial/ethnic minorities and individuals with chronic illness, it could be facing a $14 trillion price tag by 2040, the report authors calculated.

"As a practicing physician, I see the correlation between how chronic conditions can exacerbate mental health challenges and economic strains that impact my patients' overall health," said Jay Bhatt, D.O., MPH, MPA, the managing director of the Deloitte Center for Health Solutions and the Deloitte Health Equity Institute, in a statement.

"With my patient experiences coupled with the findings from this report, there's no denying that there is an urgent need to make mental health more visible and prioritize actions to improve health outcomes and reduce costs associated with managing these conditions," Bhatt said.

Indeed, access to mental healthcare is different across race/ethnicity. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), American Indian/Alaska Native (AI/AN), Black, Hispanic and Asian people access mental healthcare at lower rates than their white counterparts.

Mental health conditions, challenges and illnesses often co-occur with other chronic diseases. When left untreated, mental health conditions can turn into avoidable healthcare encounters that come with a high price tag.

This latest report from Deloitte and Meharry outlines the economic burden of inequitable mental healthcare, ranging from inequitable access to outcomes disparities.

In addition to the $14 trillion price tag the U.S. can anticipate come 2040, the researchers said the nation is facing the high cost of mental health inequities right now. Currently, the U.S. spends an estimated $477.5 billion each year on avoidable expenses that are related to mental health inequities. That includes $5.3 billion each year on emergency department (ED) utilization.

The cost of avoidable mental health emergencies due to inequitable access is only slated to grow, the assessment continued. By 2040, the Deloitte and Meharry researchers estimated the U.S. would spend $1.26 trillion each year on costs related to mental health inequities. That includes an estimated $17.5 billion in ED utilization.

The report also examined the link between chronic conditions and mental health, finding that nearly everyone with a mental health condition has a higher prevalence of chronic conditions, regardless of age. This is especially pronounced among individuals with lower incomes. Low-income people with mental health conditions are more likely to have diabetes, HIV/AIDS and stroke, the analysis showed.

"This report builds on my 2022 study examining the past economic burden of mental health inequities in the United States," said Daniel Dawes, JD, the founding dean of the School of Global Health at Meharry Medical College, in the press release. "In recognizing the compelling correlation between brain health and chronic conditions, we determined that in order to have a more complete picture of the costs of mental health in America, we needed to understand the present and future costs of inequities in mental health and physical health conditions."

As the U.S. continues to stem the rising tide of excess health spending, the report authors suggested that greater investment in mental healthcare and integrating it with chronic disease management will be essential. Moreover, closing outcomes disparities will hinge on addressing differences in mental healthcare access, they stated.

"We urge employers, clinicians, researchers, advocates, policymakers and community leaders to unite in catalyzing actionable solutions to address these pervasive and increasingly costly mental health inequities," Dawes concluded. "Now is an opportune moment to proactively shape the mental health landscape for millions by addressing this pressing issue and intentionally developing cost-effective community-designed interventions."

This study follows a 2022 report from Dawes and researchers from the Satcher Health Leadership Institute at Morehouse School of Medicine with support from Otsuka America Pharmaceutical Inc. The report found that racial mental health disparities cost the U.S. around $278 billion between 2016 and 2020.

Most of the excess cost burden is concentrated among Black and Hispanic individuals; in other words, if Black and Hispanic individuals experienced the same mental and behavioral healthcare as their white peers, there'd be a cost savings of $131.6 billion and $114.5 billion during the study period, respectively.

The researchers also found a $23 billion excess cost due to years of life lost among unhoused people.

Sara Heath has been covering news related to patient engagement and health equity since 2015.