Associations of serious mental illness with earnings: results from the WHO World Mental Health surveys

Br J Psychiatry. 2010 Aug;197(2):114-21. doi: 10.1192/bjp.bp.109.073635.


Background: Burden-of-illness data, which are often used in setting healthcare policy-spending priorities, are unavailable for mental disorders in most countries.

Aims: 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.

Method: 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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Cost of Illness*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Employment / economics
  • Employment / statistics & numerical data
  • Global Health*
  • Health Surveys
  • Humans
  • Income / statistics & numerical data*
  • International Classification of Diseases
  • Mental Disorders / economics*
  • Mental Disorders / epidemiology
  • Middle Aged
  • Regression Analysis
  • Risk Factors
  • Severity of Illness Index
  • Sex Distribution
  • World Health Organization
  • Young Adult