Mental health treatment expenditure trends, 1986-2003.
OBJECTIVE
This study determined spending on mental health treatment in the United States over time by provider and payer relative to all health spending.


METHODS
Estimates were developed to be consistent with the National Health Expenditure Accounts. Numerous public data sources were used.


RESULTS
Mental health treatment expenditures grew from $33 billion in 1986 to $100 billion in 2003. In real 2003 dollars, spending per capita on mental health treatment rose from $205 to $345. The average annual nominal total mental health growth rate was 6.7%. In comparison, total health care expenditures increased by 8.0%. As a result of the slower growth rate of mental health expenditures compared with all health spending, mental health fell from 8% of all health expenditures in 1986 to 6% in 2003. Total national health spending increased by approximately $1.175 trillion from 1986 to 2003; of this, 6% is attributed to an increase in mental health spending. The mix of services has changed, with more care being provided through prescription drugs and in outpatient settings and less in inpatient settings. Payer mix has also shifted, with Medicaid taking a more prominent role.


CONCLUSIONS
Spending on mental health treatment has increased over the past decade, reflecting increases in the number of individuals receiving mental health treatment, particularly prescription drugs and outpatient treatment. Changes in payer and provider mix raise new challenges for ensuring quality and access.
Mark
Tami L
TL
Thomson Healthcare, 4301 Connecticut Avenue N.W., Washington, DC 20008, USA. tami.mark@thomson.com
Levit
Katharine R
KR
Buck
Jeffrey A
JA
Coffey
Rosanna M
RM
Vandivort-Warren
Rita
R
D003695:Delivery of Health Care / Q000191:economics; D016527:Drug Costs / Q000639:trends; D005382:Financing, Personal / Q000191:economics; D005102:Health Expenditures / Q000639:trends*; D006297:Health Services Accessibility / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D007358:Insurance, Psychiatric / Q000191:economics; D008484:Medicaid / Q000191:economics; D001523:Mental Disorders / Q000191:economics* / Q000534:rehabilitation; D008605:Mental Health Services / Q000191:economics*; D011619:Psychotropic Drugs / Q000191:economics; D014481:United States
D011619:Psychotropic Drugs