TOPLINE

Annualized mental health care expenditures in the US, including those for substance use disorders, totaled $174 billion during 2021-2023, representing 7% of all medical spending, but remained low with respect to the population-level burden of mental health conditions, a study showed. Mood and anxiety disorders accounted for the highest aggregate costs, whereas mean per-person expenditures were highest for substance use disorders, schizophrenia, and bipolar disorders.

METHODOLOGY

• In a cross-sectional analysis, researchers analyzed data from the 2021-2023 Medical Expenditure Panel Survey, which represented the civilian noninstitutionalized US population.
• Of the 67,532 person-year observations (mean age, 39.8 years; 50.7% female), 15,407 (mean age, 45 years; 60% female) involved outpatient mental health care.
• Mental health care was defined by office-based or hospital outpatient visits for a mental health diagnosis, visits to mental health care professionals, visits for psychotherapy, or psychotropic medication expenditures.
• Researchers estimated aggregate mental health care expenditures, mean expenditures per 100 persons, and mean expenditures per treated person, stratified by sociodemographic characteristics, insurance type, mental health disorder categories, and service type.
• Spending covered office-based and other outpatient care, hospital stays, prescription medicines, and home health services, with household interview data supplemented by information from providers.

TAKEAWAY

• Annual aggregate total healthcare expenditures were $2.5 trillion, of which mental health expenditures were $174 billion (7%). Mean annual expenditures were $523 per person overall and $2473 per person among those with any treated mental health disorder.
• Mood disorders ($74 billion) and anxiety and fear-related disorders ($69 billion) accounted for the highest aggregate expenditures. Mean per-person expenditures were highest for substance use disorders ($9569), schizophrenia ($9370), and bipolar disorders ($7382).
• Ambulatory services accounted for the largest share of the spending at $107 billion, followed by medication ($36 billion), home healthcare ($20 billion), and inpatient treatment ($12 billion).
• Mean per-person expenditures were higher for individuals who were female (vs male) or nonmarried (vs married) and lower for individuals who were aged 65 years or older (vs aged < 18 years), Asian and Hispanic (vs non-Hispanic White), or uninsured (vs insured). Mean expenditures per treated person were higher for individuals who were younger than 18 years (vs adults), Hispanic (vs non-Hispanic White), never-married (vs married), or from lower-income families (vs from higher-income families) and lower for uninsured individuals (vs insured).

IN PRACTICE

"In this cross-sectional study, although expenditures on mental health disorders vary widely at the per-person and population levels, they are consistently low relative to the societal burden of mental disorders. Research that leads to more effective treatments, decreases provision of low-value care, and supports better matching of patients' impairment with the appropriate level of care could help optimize treatment access while controlling expenditures," the investigators wrote.

SOURCE

The study was led by Carlos Blanco, MD, PhD, National Institute on Drug Abuse, Bethesda, Maryland. It was published online on September 30 in JAMA Psychiatry.

LIMITATIONS

The study was limited by its sample size, which prevented some estimates and led to large standard errors. The survey excluded populations with high mental health burden, including incarcerated and unsheltered individuals, and did not capture institutional care, potentially underestimating total expenditures. Additionally, nearly half of mental health encounters had fully or partially imputed expenditures.

DISCLOSURES

Funding information was not provided for the study. The investigators reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.