|
Inspire Foundation
PO Box 1790
Rozelle NSW 2039
T. +61 2 8585 9300
F. +61 2 8585 9349
E. info@inspire.org.au
www.inspire.org.au
REPORT SUMMARY
Counting the Cost: The Impact of Young Men’s Mental Health on the Australian
Economy
Executive Summary
The human and economic costs of
mental illness in Australia can no longer be ignored.
The Australian Institute of Health and Welfare reports that approximately 26.5%
(one in four young people in this age
group) will experience a mental health difficulty.
In spite
of this, rates of help-seeking among young Australians, and particularly among
young men, remain low. Tragically, suicide continues to be the leading cause of
death for young men in Australia, accounting for 22% of all deaths;
with male youth suicide rates in rural
areas double those of metropolitan areas.
This report analyses the resultant cost and impact on the
Australian economy, highlighting the threat to productivity from poor mental
health among young men. In presenting this new evidence, this report
provides a call-to-action, demonstrating the importance of a community-wide
response to raising awareness, prevention and treatment of young men’s mental
illness.
The cost
of mental illness on the Australian economy
Our research identifies costs and impacts to the Australian economy and
productivity which are borne across a range of sectors and institutions. The
findings of our research and modelling reveal the broader costs to individuals
and employers:
• Mental illness in young men aged 12-25
costs the Australian economy $3.27 billion per annum or $387,000 per hour
across a year in lost productivity
• The Federal Government bears 31% of this cost via -
* direct health
costs,
* disability
welfare payments,
* unemployment
benefits; and
* direct costs of
imprisonment
• Australia loses over 9 million working days per annum to young men with mental
illness. On average they have an additional 9.5 days out of role per year
• Young men with mental illness have much lower rates of educational attainment
compared to their peers, further limiting their skills development and long term
reduced earning potential by $559 million per year Government incurs significant
costs associated with the provision of mental health services:
• In 2008, the overall cost of spending
on mental health care was $5.32 billion, with the Australian government spending
$1.92 billion and the states and territories spending $3.22 billion
• In addition to the costs associated directly with specialist mental
health care, the government also bears a broad range of costs required to
support people with mental illness - including income support, housing services,
domiciliary care and employment and training opportunities
• The 2010 National Health Report estimated that with government costs alone,
for every dollar spent on specialised
mental health care, an extra $2.30 is spent on other services to support people
with mental illness – equating to $4.4 billion (2008 prices)
Our recommendations
The reality is that the costs of young men’s poor mental health are already
being felt throughout Australia’s economy. In uncovering these costs, this
report provides new insights that can be used to guide further reforms and
investment decisions. Failure to act presents a serious threat to
Australia’s future productivity and to the individual prosperity of young men
affected with poor mental health. Coordinated
activity from all sectors – business, government, and communities – holds the
promise of considerable economic and individual benefits.
The
findings of this study point to both the productivity opportunities and risks
associated with the mental health of young men.
Recommendation 1:
Efforts
should be made by all sectors of the community to support the engagement of
young men to achieve higher levels of
education.
• 1.1 Improve secondary, tertiary and vocational educators’ levels of
understanding of mental health, including the identification of disorders and
awareness of support and referral services available. This should include
professional development and tools for teachers and other educators
• 1.2 Increase awareness and access for
young men to educational alternatives such as apprenticeships
• 1.3 Strengthen cross sector partnerships between employers and education
providers to create stronger pathways
from school to work for young men with mental illness. This should
include focus on key transition points such as moving from school to further
studies or employment
Recommendation 2:
Efforts
should be made by all sectors of the community to support young men with mental
illness to engage in more productive
employment.
• 2.1 Improve employers’ level of understanding of mental health, including the
identification of disorders and awareness of support and referral services
available
• 2.2 Initiate new partnership models between government, mental health service
providers, NGOs, employers and business groups to create strategies that
proactively support employees’ good mental health and ongoing engagement in the
workforce
• 2.3 Identify new partnership models between employers, business groups,
government and NGOs to drive a whole of community response. This includes
creating new collaborative funding and service delivery models
Recommendation 3:
Efforts
should be made by all sectors of the community
to evaluate the effectiveness of current
policy responses and investments in mental health.
• 3.1 Undertake further targeted research to evaluate the efficacy of existing
mental health programs and interventions with a particular emphasis on
prevention and early intervention
• 3.2 Undertake return on investment analysis to inform future investment in
young men’s mental health with a particular emphasis on prevention and early
intervention
• 3.3 Enhance reporting of government funded initiatives targeted at supporting
young men with mental illness to achieve full benefits of investment.
Summary of Findings
Cost and Impact: Individuals
Our analysis found that individuals bear costs of mental illness of $2.016
billion per annum.
Young men bear the cost of factors associated with health, reduced productivity
and education, lost income and mortality.
Health
• The total direct health cost per year is $556 million, of which $179
million is incurred by individuals
Employment
• Young men
with mental illness have on average 4.7% lower hourly wages relative to their
peers with the same level of educational attainment. The cost to individuals in
reduced personal income due to lower wages is $445 million per annum
• 48.1% of young men within the cohort have no qualifications beyond high
school. The cost to individuals in reduced personal income due to lower wages is
$114 million per annum
• Young people with mental illness have lower levels of educational
qualifications and when they do gain employment tend to obtain lower skilled
poorly paid roles
Unemployment
• Young men with a mental illness are 1.6 times more likely to be unemployed
relative to a person who does not have a mental illness
• Lost income in young men with mental illness who are actively looking for work
but unemployed is $168 million per annum
Imprisonment
• The ABS National Survey of Mental Health and Wellbeing reports that
5% of all mentally ill people have ever
been incarcerated in their lifetime, relative to 1.8% of the non-mentally ill.
This reflects a relativity of 2.8 times the prevalence of non-mentally ill young
men
• Lost income in young men with mental illness who are imprisoned is $54 million
per annum
Disability
• The literature shows there are wider indirect costs to individuals with mental
illness and their families such as carers’
costs, psycho social costs such as stress, pain and suffering and other indirect
costs such as reduced income for
carers. These costs have not been quantified in this model
Mortality
• Mortality rates are significantly higher for young men with mental illness
compared to young men who do not have
mental illness
• Loss of lifetime earnings in young men due to mental illness related mortality
– including from death by suicide – is
$1.057 billion per annum
Cost
and Impact: Employers
Our analysis found that employers bear direct costs of mental illness of $237
million per annum. This is primarily due to the
costs associated with additional personal leave taken by the cohort.
There are, however, impacts from other cost categories that have an indirect
impact on employer productivity.
Health
• Work that is both stressful and insecure can increase the risk of depression
up to 14 times relative to jobs in which
individuals feel a sense of control and are securely employed
• The negative impact that poor mental health has on the individual may extend
to co-workers who may experience
increased stress through having to carry out additional work tasks
Employment
• Young men with mental illness take an additional 9.5 days out of role per
year over and above people without mental
illness. This equates to a loss of over 9 million working days due to mental
illness across Australia per year
• The marginal cost to employers due to additional days out of role is $237
million per annum
Cost and Impact: Government
Our analysis found that government bear costs of mental illness of $1.019
billion per annum.
Government bear the cost associated with health, welfare (unemployment and
disability pensions) and imprisonment.
Health
• The total direct health cost per year is $556 million, of which $377
million is incurred by government
• Government spend on mental health increases significantly from 15-25 years
($205m) to 25-34 years ($306m) and
again for 35-44 years ($268m), before declining until the 75+ group
Unemployment
• Young men with a mental illness are 1.6 times more likely to be unemployed
relative to a person who does not have a mental illness
• Marginal unemployment payments disbursed to young men with a mental illness
cost the government $62 million per annum
• This is an opportunity cost to government
Imprisonment
• The government incurs $207 million per annum in direct costs related to
the higher rates of imprisonment experienced
by young men with a mental illness
• The health costs of caring for mentally ill prisoners is not included in this
study due to lack of data
Disability
• Disability welfare payments paid to young men who experience poor mental
health cost the government $373 million
per annum
Mortality
• Potential cost offsets to
government associated with premature mortality (such as future health costs
avoided) were not included in the model
Key Conclusions & Recommendations
Key Conclusion 1:
Education
plays a significant role in the employment outcomes of young men with mental
illness. Research shows that education and training opportunities can act
as a protective factor against mental health issues, whilst secure and good
employment outcomes provide young people with the possibility of financial
independence, a sense of control, self-confidence and social contact.
Education
plays a significant role in the employment outcomes of young men who experience
mental illness. In Australia, individuals who have a degree or a higher
qualification earn wages 30 to 45% higher than people with otherwise similar
characteristics who have not completed Year 12. A university education
increases men’s wages by approximately 38% and also increases the probability of
employment by 15-20%. Education levels also influence the types of employment
men are able to obtain.
Of particular significance, mental
illness typically begins in adolescence/early adulthood - a time when
individuals are completing their education and pursuing employment options. The
impact of youth mental illness on schooling through factors such as increased
absenteeism, dropout rates and difficulty learning can compound the potential
negative impacts on
employment outcomes.
The impact of reduced education is very real for young men with mental illness,
earning 4.7% lower hourly wages compared to
their peers, and almost half do not have a qualification beyond high school. As
a consequence, young men with mental illness
are often employed in lower skilled, poorly paid roles.
Higher education is positively linked to wages and productivity. Higher wages in
turn also have an impact on health and
education through providing the resources to access educational and health
services.
Recommendation 1.
Efforts
should be made by all sectors of the community to support the engagement of
young men to achieve higher levels of
education:
• 1.1 Improve secondary, tertiary and vocational educators’ levels of
understanding of mental health, including the identification of disorders and
awareness of support and referral services available. This should include
professional development and tools for teachers and other educators
• 1.2 Increase awareness and access for young men to educational alternatives
such as apprenticeships
• 1.3 Strengthen cross sector partnerships between employers and education
providers to create stronger pathways from school to work for young men with
mental illness. This should include focus on key transition points such as
moving from school to further studies or employment
Key Conclusion 2:
Employers
bear a significant impact in direct costs of absenteeism and reduced
productivity.
Employers and business groups are crucial stakeholders.
All indications show Australia will continue to face productivity challenges
into the future, with an ageing population in particular expected to place
increased pressure on Australia’s labour supply. The ‘Australia
to 2050: future challenges’ report highlights the need to improve
labour participation rates, suggesting that ‘policy responses need to reflect a
sound understanding of the complex nature of mature age participation.’
The report goes on to acknowledge the importance of policies that target
improvements in education and health – factors which are also crucial to the
workforce participation of the 496,000 young men experiencing mental illness.
For men who are suffering from poor mental health in particular,
research shows that treating or
preventing mental illness can potentially improve their chances of participating
in the workforce by up to 30%.
Addressing poor mental health in the workplace environment has the direct
benefit of the avoiding costs of absenteeism and also has the potential to
reduce flow-on effects to co-workers by not having to carry additional work
tasks. Engaging employers and business groups in the development of and
delivery of mental health initiatives will assist in cultivating a larger,
higher skilled and more productive Australian labour force.
Recommendation 2.
Efforts
should be made by all sectors of the community to support young men with mental
illness to engage in more productive
employment:
• 2.1 Improve employers’ levels of understanding of mental health, including the
identification of disorders and awareness of support and referral services
available
• 2.2 Initiate new partnership models
between government, mental health service providers, NGO’s, employers and
business groups to create strategies that proactively support employees’
good mental health and ongoing engagement in the workforce
• 2.3 Identify new partnership models between employers, business groups,
government and NGOs to drive a whole of community response. This includes
creating new collaborative funding and service delivery models
Key
Conclusion 3:
Deepening our understanding of the
efficacy and return on investment of current policy responses and programs in
mental health is critical to driving targeted investment.
The cost impact identified in this report suggests that further analysis of
current policy responses to young men’s mental health be undertaken to determine
the efficacy and impact of these interventions.
As our findings suggest, investing
smarter and earlier in young men has the potential to reduce the mental health
cost and impacts on individuals and the Australian economy. Further
research on return on investment for existing mental health services targeted at
young men is essential to inform investment decisions.
Smarter and targeted investments across the spectrum of mental health services
will have the added benefit of improving national productivity. By increasing
the capacity of young men with mental illness to meaningfully participate in
work and community life the prosperity of the nation will be improved.
Recommendation 3:
Efforts
should be made by all sectors of the community to evaluate the effectiveness of
current policy responses and investments in mental health:
• 3.1 Undertake further targeted research
to evaluate the efficacy of existing
mental health programs and interventions with a particular emphasis on
prevention and early intervention.
• 3.2 Undertake return on investment analysis to inform future investment in
young men’s mental health with a particular emphasis on prevention and early
intervention
• 3.3 Enhance reporting of government funded initiatives targeted at supporting
young men with mental illness to achieve full benefits of investment. Key
objectives of these enhancements are to drive greater accountability of public
spend and to provide better transparency and access to program performance and
evaluation
The full
report can be downloaded at
www.inspire.org.au and
www.youngandwellcrc.org.au
For
further information or media enquiries, please contact Louise Tran at Liquid
Ideas: louisetran@liquidideas.com.au 0466 620 744 or 02 9667 4211
Focusing on
individual disorders, specific phobia is generally found to be the most
prevalent mental disorder in community epidemiological surveys, with lifetime
prevalence estimates usually in the 6–12% range and 12-month prevalence
estimates in the 4–8% range (Silverman & Moreno, 2005). Major depressive
disorder (MDD) is generally found to be the next most prevalent disorder, with
lifetime prevalence estimates usually in the 4–10% range and 12-month prevalence
estimates in the 3–6% range (Judd & Akiskal, 2000). Social phobia is generally
found to be the next most prevalent disorder, with prevalence estimates
sometimes approaching those of MDD (Furmark, 2002). The WMH estimates are
generally quite consistent with these more general patterns.
|