Associations of serious mental illness with earnings: results from the WHO World Mental Health surveys

Background Burden-of-illness data, which are often used in setting healthcare policy-spending priorities, are unavailable for mental disorders in most countries. Aims To examine one central aspect of illness burden, the association of serious mental illness with earnings, in the World Health Organization (WHO) World Mental Health (WMH) Surveys. Method The WMH Surveys were carried out in 10 high-income and 9 low- and middle-income countries. The associations of personal earnings with serious mental illness were estimated. Results Respondents with serious mental illness earned on average a third less than median earnings, with no significant between-country differences (chi(2)(9)=5.5-8.1, P=0.5-0.79). These losses are equivalent to 0.3-0.8% of total national earnings. Reduced earnings among those with earnings and the increased probability of not earning are both important components of these associations: Conclusions These results add to a growing body of evidence that mental disorders have high societal costs. Decisions about healthcare resource allocation should take these costs into consideration.

Bristol-Myers Squibb

Eli Lilly Company

GlaxoSmithKline

Johnson & Johnson Pharmaceuticals

Ortho-McNeil Pharmaceuticalsc

Pfizer

Sanofi-Aventis

WHO World Health Organization World Mental Health (WMH) Survey Initiative

United States National Institute of Mental Health (NIMH/NIH)[R01MH070884]

mental Health Burden Study[HHSN271200700030C]

John D. and Catherine T. MacArthur Foundation

Pfizer Foundation

US Public Health Service[R13-MH066849]

US Public Health Service[R01-MH069864]

US Public Health Service[R01 DA016558]

Fogarty International Center (FIRCA/NIH)[FIRCA R03-TW006481]

Pan American Health Organization (PAHO)

Eli Lilly & Company Foundation

Ortho-McNeil Pharmaceutical Inc

Shire

State of Sao Paulo Research Foundation (FAPESP)[03/00204-3]

Ministry of Health of Bulgaria

Shenzhen Bureau of Health

Shenzhen Bureau of Science, Technology, and Information

Ministry of Social Protection

European Commission[QLG5-1999-01042]

European Commission[SANCO 2004123]

Piedmont Region (Italy)

Fondo de Investigacion Sanitaria

Institut de Salud Carlos III, Spain[FIS 00/0028]

Institut de Salud Carlos III, Spain[CIBER GB06/0210046]

Institut de Salud Carlos III, Spain[RETICS RD06/0011 REM-TAP]

Ministerio de Ciencia y Tecnologia, Spain[SAF 2000-158-CE]

Departament de Salut, Generalitat de Catalunya, Spain

WHO (India)

Ministry of Health

Japan Ministry of Health, Labour and Welfare[H13-SHOGAI-023]

Japan Ministry of Health, Labour and Welfare[H14-TOKUBETSU-026]

Japan Ministry of Health, Labour and Welfare[H16-KOKORO-013]

Lebanese Ministry of Public Health

WHO (Lebanon)

Fogarty International (FIRCA/NIH)

Janssen Cilag

Eli Lilly

Roche

Novartis

National institute of Psychiatry Ramon de la Fuente[INPRFMDIES 4280]

National Council on Science and Technology[CONACyT-G30544-H]

New Zealand Ministry of Health, Alcohol Advisory Council

Health Research Council

WHO (Geneva)

WHO (Nigeria)

Federal Ministry of Health, Abuja, Nigeria

US National Institute of Mental Health (NIMH/NIH)[R01-MH059575]

National Institute of Drug Abuse (NIDA/NIH)

South African Department of Health

University of Michigan

US National Institute of Mental Health (NIMH/NIH)[U01-MH60220]

Substance Abuse and Mental Health Services Administration (SAMHSA)

Robert Wood Johnson Foundation[044708]

John W. Alden Trust