Results from a survey conducted by the World Health Organization (WHO) in low-, middle-, and high-income countries show that people with serious mental health disorders earn, on average, one third less than people without mental health issues.

Writing in the British Journal of Psychiatry, Ronald Kessler (Harvard Medical School, Boston, Massachusetts, USA) and team explain that, “although a considerable body of empirical research has used the human capital approach to document adverse societal effects of mental disorders, this research has been carried out largely in a small number of high-income countries.”

They add: “Yet epidemiological data show that mental disorders are common throughout the world.”

To investigate the effects of serious mental illness on earnings in a wider range of countries, the researchers studied data from WHO World Mental Health (WMH) surveys conducted in 10 high- and nine low- and middle-income countries.

All respondents were asked to report their personal earnings in the past 12 months. Mental illness within the past 12 months was assessed via the WHO Composite International Diagnostic Interview using DSM-IV criteria for anxiety and mood disorders, such as bipolar disorder and major depressive disorder.

In total, 101,825 participants were interviewed, with individual country sample sizes ranging from 2372 in The Netherlands to 12,992 in New Zealand.

The researchers found that the prevalence of serious mental illness was significantly higher in high-income countries than in low- and middle-income countries both in the total sample (4.3% vs 3.0%) and considering men (3.5% vs 2.2%) and women (5.0% vs 3.9%) separately.

After accounting for factors such as age, gender, and between-country differences in earnings, the researchers found that people with serious mental illnesses earned an average of 32-33% less in the past 12 months than mentally healthy individuals.

Indeed, serious mental illnesses were associated with a reduction in population-level earnings equivalent to 0.8% of all earnings in high-income countries and 0.3% of all earnings in low- and middle-income countries.

“These comparisons make it clear that mental disorders are associated with massive losses of productive human capital not only at the individual level… but also at the societal level in the WMH countries,” Kessler and team conclude.

“Decisions about healthcare resource allocation should take these costs into consideration.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

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