How public sector investment can address the mental health crisis


Mental health used to be rarely spoken about, but the current mental health crisis has been brewing for years, and the COVID-19 pandemic finally put it in the spotlight

In 2020 alone, people with mental health disabilities accounted for 29% of social security disability insurance beneficiaries in the US – more than physical injuries, cancer, circulatory problems and nervous system diseases combined.

Not only is this crisis doing untold damage to people’s well-being, but it is also having a significant negative impact on the wider economy. In the US alone, recent economic data puts the cost of mental health disability at US$317.6b annually, including US$193.2b loss of earnings, US$100.1b in health care expenditure, and US$24.3b in terms of disability benefits.

Despite the enormity of the challenge, there is currently a significant opportunity to tackle it head-on, thanks to the increased awareness of mental health, better understanding of the root causes of our current crisis, and exciting new breakthroughs in prevention, treatment, and technology.

Widening and easing access to mental health services

One of the biggest and most important challenges that need to be solved is the limited access to mental health services. Many citizens still find it extremely difficult to access mental health treatment and are often faced with a slow, fragmented, and bureaucratic system.

Telehealth, the use of technology to monitor, control or manage health remotely, is already playing a significant role in solving the capacity challenge. Its adoption was accelerated during the pandemic, with around 50% of in-person mental health visits in 2020 transitioning to virtual consultations. Now, even more patients and clinicians are using telehealth platforms, helping to significantly reduce travel times and increase the number of consultations that health providers are able to offer each day.

Digital tools can also be used to make it easier to train and attract the next generation of mental health professionals, which will again help to widen and increase access to services. For example, UNICEF recently created the Caring for the Caregiver program that delivers online and in-person courses on a range of mental health topics that can be accessed through local universities and colleges.

Governments should develop “second-tier” responders to support the ongoing mental health crisis

Lastly, to help expand access within underserved communities, governments should look at developing teams of “second-tier” responders who can act and deal with the initial causes of mental health. Australia has already done this by rolling out a nationwide plan that will help teachers to better understand, respond and look out for the signs of mental health issues within the classroom. This is especially important in deprived regions, where students have a greater likelihood of coming from disadvantaged backgrounds, which has a correlation with the incidence of mental health challenges.

Some solutions can be a bit more analogue: for example, in the US, The Confess Project of America is a national organization supporting local chapters that train barbers and stylists to become mental health advocates, with the mission to build awareness and break stigmas around mental health within the Black community.

They’ve trained over 2,000 barbers across the country and are reaching over 2.4m people per year.

In Zimbabwe, The Friendship Bench Project mainly uses older women as counsellors because these “grandmothers” tend to be respected and trusted. At state-run clinics around the country, there are benches under trees where patients can speak to trained volunteers for free about their worries and problems.

Investing and lowering the cost of mental health treatment to combat the mental health crisis

Currently, less than 2% of national health budgets globally are spent on mental health, while two-thirds of these funds go toward treatment at general and psychiatric hospitals – rather than mental health primary and community care. Governments must therefore allocate more toward mental health, and while doing this will obviously improve the overall health of the population, it will also have a big economic impact.

For every US$1 spent on improving the two most common types of mental ailments – depression and anxiety – US$4 will be yielded in better health and productivity

Recent studies from the World Health Organization have calculated that for every US$1 spent on improving the two most common types of mental ailments – depression and anxiety – US$4 will be yielded in better health and productivity, thanks to greater participation in the labour force and worker effectiveness.

However, for many countries in the developing world, the cost is the biggest barrier to tackling the mental health crisis, which is extremely difficult to overcome.

To lower the cost, governments and the health industry should implement policies that promote early intervention and prevention strategies, potentially reducing the need for more expensive treatments later, and invest in expanding mental health infrastructure to make treatment more affordable.

Government leaders can also work toward enhancing insurance coverage and reimbursement policies for mental health services. And for those programs in existence today that lower the cost of mental health services through social program enrolment ensuring clear communication about their existence is a strong first step.

It’s not an easy challenge to solve, but it’s a critically important one. By making bigger investments and utilizing the latest health technologies, governments across the world will be able to create a holistic, integrated mental health system that provides citizens with the care and support they need to live their best, most productive, and most fulfilled lives.

The views reflected in this article are the views of the author and do not necessarily reflect the views of the global EY organization or its member firms.

This piece was written and provided by Andrea Danes, EY Global Human Services Leader.

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