Untreated Mental Illness
Once again, Colorado’s community mental health system is serving record numbers. Job losses, inadequate health insurance coverage, and record Medicaid enrollments will bring close to 100,000 men, women, and children to this vital system this year. In 2008, Colorado’s system served more than 90,000 people for the first time.
People with mental illness and/or substance use disorders are uninsured more often than most people. Approximately one-third of adults with mental illness, substance use disorders, or both who are below the federal poverty line are uninsured. Not having insurance is a significant roadblock for people with mental illness and/or substance disorders and that roadblock is a costly one.
The bad news is that the numbers of those going without mental health treatment is rising. The human toll is extreme and the economic toll is significant:
- Criminal Justice & Courts: Statewide, approximately 28 percent of all inmates have a diagnosable mental illness. These individuals are consuming a significant share of the $599 million the State of Colorado spent on corrections in 2007. Additionally, our cities and counties are spending millions more on people with mental illness as they repeatedly cycle through local courts and jails with what are often nuisance crimes. mentally ill inmates in the seven-county, Denver-metro area have an average jail stay of 121 days while non-mentally ill inmates average 25 days in jail. Offenders with mental illness also have much higher rates of recidivism due to many factors, including substance abuse, lack of access to mental health treatment, homelessness, and unemployment.
- Almost one-fourth of all stays in U.S. community hospitals—7.6 million of nearly 32 million stays— involved depression, bipolar disorder, schizophrenia, and other mental health disorders or substance use disorders.
- Two-thirds of the U.S. homeless population are adults with chronic alcoholism, drug addiction, mental illness, or some combination of the three.
- People with mental illness typically die 25 years earlier than the general population because they often have other untreated conditions such as diabetes, heart disease or cancer. Half the people with a mental health diagnosis have problems by age 14 but do not get treatment for a decade, leaving them less able to study and work, the group says. To reverse this trend, advocates for people with mental illness recently called for federal intervention, including improving the tracking of these individuals’ physical and mental health;removing obstacles to their receiving quality, integrated physical and mental health care; and encouraging primary care providers to work in close proximity in the same facility with mental health clinicians to improve provision of that care.
- Mental health disorders and addiction cost U.S. businesses $171 billion a year in lost productivity, according to estimates from the Campaign for Mental Health Reform, an umbrella group for mental health advocates.
In addition, the costs are also taking their tolls on schools and emergency rooms. Data from the 2005 and 2006 National Survey on Drug Use and Health (NSDUH) indicate that more than one in four adults who are uninsured have a mental illness, substance use disorder, or co-occurring disorder. Almost 80 percent of people with these disorders who needed mental health treatment but did not receive it cited cost as the reason.
Underinsurance is also a problem: 34 percent of insured people who had unmet mental health needs indicated that cost was a barrier to seeking treatment.