The Cost of Conversation — Economics and Mental Health

wan mohd
wan mohd

Editor’s Note — We realize that the availability of treatment for eating disorders varies widely by region, and that even basic treatment is not always accessible financially or logistically. If you are concerned that you or someone you love has an eating disorder and wish to seek help, visit nationaleatingdisorders.org, or call 800-931-2237 to speak to a professional.

By Francesca Baker

The second week of October 2014 was Mental Health Week in the UK, a small frenzy of activity I watched with interest. The ever-decreasing funding for mental health on Britain’s National Health Service and ever-increasing waiting lists for mental health treatment has long been an area of controversy. The direction of financial support is a manifestation of the continued discrimination and misunderstanding of the illnesses that fall under this umbrella, and physical and visible ailments (while still being hit by funding cuts) are still more likely to be treated.

It’s not that mental illnesses are difficult to understand, more that they are so often neglected or ignored. Our mental and emotional wellbeing and health is neglected and ignored until — until what? Until a very obvious, tangible, physical manifestation of the discomfort, the dis-ease, is made evident. This applies to anything, from heart problems to alcoholism, self-harm, eating disorders, or even suicide.

These illnesses are not all in the mind, nor can they be fully resolved by a quick chinwag over a good cuppa, but neglecting to treat an illness until it has manifested itself physically is harmful. Whether it’s talking therapies or behavioral programs, something must be done to treat the root cause, and early intervention is crucial.

Not only for the person suffering, but for the health service as a whole.

If mental health issues continue to be untreated, the physical manifestations will also continue to get worse. For example, stress levels may give rise to heart problems, which cost the NHS millions each year. Alcoholism is a huge stress on the service, the physical damage caused by alcohol abuse being the result of the mental illness that it is.

Mental illness represents up to 23% of the total burden of ill health in the UK — the largest single cause of disability. Nearly 11% of England’s annual secondary care health budget is spent on mental health, and nearly £2 billion is spent annually on social care for people with mental health problems. 43% of the 2.6 million people on long-term health-related benefits have a mental illness. £8.4 billion is lost every year as a result of absence from work due to mental health problems, which also costs the UK economy £15.1 billion in reduced productivity.

It’s estimated that eating disorders alone cost the economy £1.26 billion per year, when taking into account the physical, social, educational, economic, and healthcare costs.

As a result of my eating disorder, my quality of life and my physical health have been compromised. I wonder if things could have been different. I don’t mean if I’d never started a diet, or never considered running, or never had low self-esteem. None of those things.

Instead, I mean, what if I had gotten help when I asked for it the first time?

Eight years ago, I went to see my doctor with concerns about my preoccupation with food and desire to lose weight. He referred me to the local Eating Disorders Unit. I was 19, had just started university, and my weight was on the border of underweight. I was told by the “specialist” assessing me that she saw girls far skinnier than me all the time, I didn’t have much of a problem, and that “no one actually wants to be fat anyway.”

Three months later, I ran to the doctor and requested hay fever tablets. “Yes, whatever, have some antihistamine,” she said. “We have more pressing concerns.” I raised my eyebrows. “You are emaciated,” she said.

I had lost a lot of weight, and was now far below the recommended minimum for my height. Not just unhealthy, but dying. I needed help earlier, but to get help I needed to physically demonstrate it.

The problem is, after hitting such a low level it’s hard to recover. I have gotten better, and worse, and better, and worse. Years later, after some ups and downs, I reached my lowest point. And despite promises for “parity of esteem” between provisions for mental and physical health services, the treatment and service from the NHS hasn’t improved either.

I’m not blaming anyone for my eating disorder. Whether it comes from genes, outside pressures, society, upbringing, social influences, miswiring, or even my choice, it is a fact. But I think about its cost. Not only the cost of lost friendships, broken relationships, betrayed loves, parental heartbreak, sibling worry, missed opportunities, but the financial cost. The longer mental health problems remain unseen, stigmatized, and untreated, the worse they become, and the greater the losses people experience in all areas of their lives. When evidence suggests that half of all mental illnesses begin by the age of 14, and three-quarters by mid-20s, the case for early intervention becomes even clearer.

Perhaps really what I’m asking is why they wouldn’t just give me someone to talk to. Is that too much to ask?

How much would six weeks talking to a therapist have cost, compared to these past eight years of treatment? Eight years of outpatient, day patient, inpatient, CBT, art therapy, body image work, music therapy, group therapy, dietitians, ECGs, dexa scans, psychiatry, and psychotherapy. Health Secretary Jeremy Hunt believes that £100 million is lost every year treating physical illnesses or severe mental illnesses that could have been dealt with far ear earlier on. Perhaps I should be grateful even now — one in three with mental health problems do not get any help at all.

Generally, society is becoming more aware of mental health problems, but still only when things get desperate. To ignore them is a huge injustice to the individuals suffering, and to society as a whole. Dealing with things only when they reach crisis point is short-sighted and unhelpful. My experience is only one example of how even “experts” do not have an understanding of eating disorders and other issues, resulting in them saying or doing unhelpful things. The patient population is diverse — proof that mental health problems can and do affect anyone, and that social class, education, economic background, and family upbringing cannot be seen as accurate predictors of a problem.

It is all about understanding — of the illness, and of the individual experiencing it. Better training and talking therapies may not be cheap anymore, but they are certainly cheaper than hospitalization. It won’t cure an illness, but it might help prevent it reaching certain severe levels. And it needs to happen at the start. Early intervention is crucial to long-term outcomes, significantly enhancing the chances of full recovery.

Francesca Baker is a London-based writer, passionate about creativity, communication, and self-development. Working in advertising in the day, she spends her evenings penning articles on music, art, health, and the world as she sees it, as well as dreaming of travel, dancing to a new-found guitar-fueled tune, or getting lost in books. Follow her on Twitter @andsoshethinks.