The Economics of Providing Psychotherapy

Mental illness is the leading cause of global disability, accounting for one-third of disability worldwide, according to 2008 data from the World Health Organization.

The Economics of Providing Psychotherapy

Susan G. Lazar, M.D.

Mental illness is the leading cause of global disability, accounting for one-third of disability worldwide, according to 2008 data from the World Health Organization. In the United States, costs of mental illness are 7 percent of total health care expenditures, with the indirect costs substantially higher at 2 percent of U.S. GDP. Over a lifetime, 50 percent of the population will suffer from at least one psychiatric disorder, and each year, nearly 30 percent of adults have a diagnosable psychiatric disorder. Of patients treated, only 32.7 percent receive minimally adequate treatment, the greatest likelihood of receiving it being highest in the mental health service sector and lowest in the general medical sector, which treats the majority of psychiatric patients. Most U.S. psychiatric patients remain untreated or poorly treated.

Psychotherapy is often unrecognized as a low-cost, effective lever to decrease many kinds of costs caused by mental illness. Psychotherapy is defined broadly as treatment of one or more patients with psychological processes, primarily through talking, and includes a therapeutic relationship and a trained therapist. It can include individual, family, and group treatment from several theoretical orientations. Its effectiveness has been established for many conditions, and a growing body of evidence indicates that psychotherapy is cost-effective; reduces disability, morbidity, and mortality; and at times leads to a reduction of medical and surgical services.

Psychotherapy is especially cost-effective for severe disorders, including schizophrenia, bipolar affective disorder, and borderline personality disorder, by leading to improved work functioning and decreased use of hospitalization.

Read the article