How affordable is mental healthcare? The long-term impact on financial health

Those who report mental illness have disproportionately faced economic disadvantages and report greater financial stress.

Since the start of the COVID-19 pandemic, mental health has declined for many Americans, with more individuals reporting mental illness since 2019. Those diagnosed with mental illness have disproportionately faced economic disadvantages and report greater financial stress. Affordability barriers are compounding these challenges by limiting mental health access for many in need.

Among our findings:

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  • More respondents are seeking psychotherapy, behavioral health help, and treatment at an ER for mental health needs since 2019. 1
  • Respondents reporting mental illness said they have greater fears around keeping their housing, especially if they have children. 2
  • Respondents reporting mental illness were on average 66 percent more likely to report debt across all categories. 3
  • Those who report having a mental health condition but have not sought treatment are 60 percent more likely to declare mental health services unaffordable. 4
  • Those reporting having a mental illness said they were less likely to pursue education or additional training. 5
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The lower sense of financial security reported by those with mental illness underscores the importance of holistic care for behavioral health—not just treating mental illness symptoms but considering the broader needs an individual with mental illness may have. Holistic approaches, such as supportive housing and supportive employment, can improve outcomes across both healthcare and broader functioning in society. 6

A year after the pandemic began in the United States, the portion of the population reporting signs of psychological distress increased.

Our survey found 30 percent of all respondents reported having a mental illness. Younger generations, caregivers, and LGBTQ+ respondents reported mental illness at a greater frequency. 1

A year after the pandemic began in the United States, the portion of the population reporting signs of psychological distress increased.

Those with mental illness report a lower sense of financial security than those without mental illness.

Twenty percent of respondents who report mental illness disclose not being on track to meet short-term financial obligations 1 (such as rent/mortgage, groceries, transportation) compared with 12 percent of respondents who did not report mental illness. The disparity worsens when considering long-term financial goals 2 with a 14 percentage point difference in respondents with mental illness reporting they feel off track.

Across income levels, those with mental illness are more likely to report concerns about losing their current housing, highlighting that while access to affordable treatment and treatment outcomes are worse for lower-income groups, mental illness affects individuals across socioeconomic groups.

Respondents who report a mental illness and are caregivers for children are 60 percent more likely to show concern for losing their current housing than respondents who report a mental illness condition yet are not caregivers.

Behavioral health conditions can interfere with work, family, and navigation of daily life. The lower sense of financial security reported by those with mental illness highlights the importance of holistic care in supporting mental health. 3

Those with mental illness report a lower sense of financial security than those without mental illness.

Further investigation could help better understand the bi-directional relationship between debt and mental illness.

Respondents who report mental illness were on average 66 percent more likely to report debt across all categories than respondents who did not report mental illness. 1

An association exists between mental illness and higher levels of debt and debt-related stress. This association may arise from initial debt leading to stress and triggering an underlying susceptibility for mental illness. However, respondents reporting a mental illness also may have found it more difficult to maintain a stable job, making it more likely they would incur debt. 2 3 4

Further investigation could help better understand the bi-directional relationship between debt and mental illness.

Respondents overall (including both those with and without a mental illness) report mental health services as one of the least affordable essential services.

Mental health services and childcare 1 were listed by respondents as the least affordable among essential services (for example, nutritious food, internet, health insurance, reliable transportation). Respondents who report mental illness were two times more likely to perceive mental health services as unaffordable. Other studies have indicated that consumers are up to 40 percent less willing to pay for mental health services than services for generic physical health conditions. 2

Limited affordability and willingness to pay for mental health services suggests cost may be a core factor in limited access to mental health services.

Respondents overall (including both those with and without a mental illness) report mental health services as one of the least affordable essential services.

The affordability of mental health services may be a barrier to care.

Almost a fourth of respondents reported deferring healthcare, with lack of affordable treatment ranking as the #1 reason why. 1

Those who report having a mental health condition but have not sought treatment for it are 60 percent more likely to declare mental health services unaffordable. This holds true when controlling for reported household income, as those who reported mental illness but have not sought treatment were still approximately 1.7 times more likely to report mental health services were unaffordable on average. 2

Individuals are between five and six times more likely to use out-of-network providers for their behavioral healthcare needs than for physical healthcare—which could lead to higher out-of-pocket costs. 3 The lower-than-average in-network reimbursement rates for behavioral health providers may also lead to higher costs, with a high share of mental health providers not accepting insurance. 4 This places more of the financial burden of mental health services on individuals.

The affordability of mental health services may be a barrier to care.

Untreated mental health conditions can impact people’s ability to pursue education.

A study published by Mental Health America 1 found nearly nine in ten employees report that workplace stress affects their mental health, and that nearly three in five employees feel their employer does not provide a safe environment for employees who live with mental illness, demonstrating the workplace could be a challenging setting.

Fifty-one to 54 percent of those who report mental illness disclose taking at least one day off in the last 12 months as a result of burnout or stress, as opposed to 15 to 18 percent of those who did not report mental illness. 2

Mental health challenges ranked prominently as barriers for pursuing educational opportunities for those with mental illness. 3

Untreated mental health conditions can impact people’s ability to pursue education.

While there are challenges, possible actions by healthcare stakeholders could help those reporting mental illness.

While there are challenges, possible actions by healthcare stakeholders could help those reporting mental illness.

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