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APHA Scientific Session and Event Listing

Edward Norton, PhD, Department of Health Policy and Administration, University of North Carolina at Chapel Hill, CB #7411, McGavran-Greenberg Building, Chapel Hill, NC 27599-7411, 919-966-8930, edward_norton@unc.edu

Purpose: The purpose of this study is to estimate the public expenditures for persons with severe mental illness, from ages 18 - 64. Public expenditures include Medicaid medical expenditures, expenditures on inpatient and outpatient medical, mental health, and substance abuse treatment, and jail expenditures.

Methods: Regression analysis of individual-year level data is used to estimate annual public expenditures by age, gender, race, and ethnicity. The longitudinal data link individuals across the different administrative data sets and over all years. We analyze unique data from King County, Washington (including Seattle) that tracks individuals in and out of the public mental health, Medicaid, and criminal justice systems for 1994-1998. Specifically, we compare three groups: those with severe mental illness, those with a mental health diagnosis who are not severely mentally ill, and those with no mental health diagnosis.

Results: When summed over ages 18-64, public expenditures for persons with severe mental illness are more than $120,000 higher than those with no mental illness. The difference in expenditures exceeds $3,000 per year, and generally increases with age.

Conclusions: Public expenditures on persons with severe mental illness are substantial. Having estimates of the lifetime public costs of severe mental illness will help to evaluate the costs and benefits of treatments and interventions. In particular, the costs of severe mental illness reach beyond the health care system, but include the substance abuse and criminal justice systems, and this underscores the importance of early interventions that reduce the prevalence or severity of mental illness.

Learning Objectives:

• At the conclusion of the session, the participant in this session will be able to discuss the public expenditures for persons with severe mental illness, from ages 18 - 64.

Keywords: Mental Health Services, Mental Illness

Presenting author's disclosure statement:

Any relevant financial relationships? No