Associations of serious mental illness with earnings: results from the WHO World Mental Health surveys.
BACKGROUND
Burden-of-illness data, which are often used in setting healthcare policy-spending priorities, are unavailable for mental disorders in most countries.


OBJECTIVE
To examine one central aspect of illness burden, the association of serious mental illness with earnings, in the World Health Organization (WHO) World Mental Health (WMH) Surveys.


METHODS
The WMH Surveys were carried out in 10 high-income and 9 low- and middle-income countries. The associations of personal earnings with serious mental illness were estimated.


RESULTS
Respondents with serious mental illness earned on average a third less than median earnings, with no significant between-country differences (chi(2)(9) = 5.5-8.1, P = 0.52-0.79). These losses are equivalent to 0.3-0.8% of total national earnings. Reduced earnings among those with earnings and the increased probability of not earning are both important components of these associations.


CONCLUSIONS
These results add to a growing body of evidence that mental disorders have high societal costs. Decisions about healthcare resource allocation should take these costs into consideration.
Levinson
Daphna
D
Ministry of Health, Mental Health Services, Jerusalem, Israel.
Lakoma
Matthew D
MD
Petukhova
Maria
M
Schoenbaum
Michael
M
Zaslavsky
Alan M
AM
Angermeyer
Matthias
M
Borges
Guilherme
G
Bruffaerts
Ronny
R
de Girolamo
Giovanni
G
de Graaf
Ron
R
Gureje
Oye
O
Haro
Josep Maria
JM
Hu
Chiyi
C
Karam
Aimee N
AN
Kawakami
Norito
N
Lee
Sing
S
Lepine
Jean-Pierre
JP
Browne
Mark Oakley
MO
Okoliyski
Michail
M
Posada-Villa
José
J
Sagar
Rajesh
R
Viana
Maria Carmen
MC
Williams
David R
DR
Kessler
Ronald C
RC
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D017281:Cost of Illness; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004651:Employment / Q000191:economics / Q000706:statistics & numerical data; D014943:Global Health; D006306:Health Surveys; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D038801:International Classification of Diseases; D001523:Mental Disorders / Q000191:economics* / Q000453:epidemiology; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D014944:World Health Organization; D055815:Young Adult