Culture, Depression

Make The Investment: Treat Our ‘Half-Trillion-Dollar Depression’

new york times illo

Though, I didn’t do myself any favors taking the paratrooper approach to my mental illness, I saved my old company major bank by taking the big leap and quitting.

I’d been debating it for over a year, yet nearly everyone in my life insisted I needed to create another path first. Unfortunately, I’m geographically bound and the journalism skill set, for those unwilling to go the public-relations route, is limiting.

Ultimately, however, my dissatisfaction so compounded my illness I simply could not go on. Things broke down — and in a fantastic way. Rather than trying to work the system any longer in my deteriorating condition, I dropped out. Leaping was my last hope.

The decision has limited my treatment options to experimental medical trials, social services (such as they are), and doctors willing to work on a sliding scale. It sucks. No way around it.

What would have been had I received good care to begin with — say, the transcranial magnetic therapy that Aetna denied me because they still consider the FDA-cleared treatment “investigational” — I can only guess. What would be today if health insurance companies were not allowed to deny me coverage because of my recent health problems?

It is with some relief that I see a conversation starting about the full cost of depression on the workplace and the changes Obamacare is poised to bring.

Granted, it’s not the most humane measure we have at our disposal, lost work hours, but the consideration of suffering as creative despondency is a good enough place to start. It’s measurable. Better: It communicates.

Here’s Catherine Rampell writing for The New York Times Magazine in “The Half-Trillion-Dollar Depression” this week:

The mentally ill are at higher risk of poverty than their peers, which subsequently increases their need for other public safety-net services like food stamps and subsidized housing. Their use of those services, according to one recent estimate, probably costs taxpayers another $140 billion to $160 billion a year. All together, our cumulative mental-health issues — depression, schizophrenia and bipolar disorder, among others — are costing the U.S. economy about a half-trillion dollars. That’s more than the government spent on all of Medicare during the last fiscal year.

With a major expansion of health insurance slated to take effect next year under Obamacare, policy makers are obsessing over how to bring down such costs. But … it was hard not to wonder whether the best way to cut the long-term costs associated with mental illness was, paradoxically, to spend more money on directly treating it now. Economists refer to this as the cost offset, and it’s sort of like a return on an investment that comes from helping mentally ill people become more productive and less dependent on taxpayers.

She goes on to cite a 2007 study that found that employees receiving “enhanced care” options through their workplace “not only worked longer weeks than those in the other group but also demonstrated greater job retention” that benefitted the company to the tune of $1,800 per worker, per year.

And what could be a made-to-order plug for TMS and other, less well-known treatments still subject to insurance resistance, Rampell writes: “One way to address the quality-of-care issue is to invest in more comparative-effectiveness research, which is a fancy term for pitting health care options head to head to see which works best for which patients and under what circumstances.”

Yes and yes. Pills may be cheaper, but they’re not the end-all, be-all of recovery. Cognitive therapy, group therapy, nutraceuticals and dietary management, exercise and meditation, and, yeah, magnetic treatments like rTMS, have all shown themselves of comparable value in different settings at different times. It’s past time to get smart about 1. making the investment in people to begin with, and 2. using all the tools in the tool box: starting with what works best for each individual.


4 thoughts on “Make The Investment: Treat Our ‘Half-Trillion-Dollar Depression’

  1. Agreed, 100%. It never ceases to amaze me how rotten “the system” is, respective of anything but a big, fat, cocktail of pills- pills which oftentimes CAUSE more health issues, requiring even MORE treatments- again, usually some pill. I am also hoping with everything in me that this bill can be used for a more tailored therapy option for those seeking it.

  2. I went through a rigmarole of brain tests, heart tests, blood tests, xrays, ctscans and whatever else for two years only to finally land on the fact that I have severe anxiety disorders. Even then I was never so horrifically treated then when I was admitted for my second suicide attempt and a nurse forcibly shoved a catheter in me to get me out of her way faster. I can’t believe with all the visible trauma in this world we’re still fighting to be heard and treated like actual people and not pathological liars and psychopaths. I’m lucky enough to receive free treatment but it’s always limited and my doctor changes every six months. Sometimes I don’t even want to try.

  3. keep up the good fight. I don’t have any mental health issues that I know of but I do fit the transgender criteria in the DSM. I saw a US article on FB that talked about how tg people can now change their gender on their social security form. We can do that already here in Oz. So one less thing to get depressed about when accessing Medicare.

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