The United States spends approximately $113 billion dollars per year on mental health care and $600 billion dollars per year on substance abuse. These figures not only include the cost of treatment but also account for lost wages, legal fees, the cost of imprisonment, prevention services, and the cost of medical complications resulting from these disorders. This may sound like an enormous amount of money, and it is, but when compared to the larger picture this amount is quite small; only about six percent of the national healthcare spending goes towards mental health treatment and services despite the rising cost of mental health. Approximately one in five adults are diagnosed with a mental illness each year, and approximately eight percent of adults in the U.S. are diagnosed with a substance use disorder each year. Studies have shown nearly 60% of adults who have a mental health disorder do not seek treatment, and an even more significant percentage of people do not seek treatment for their substance abuse disorder. The majority of these individuals do not receive treatment simply because it is too expensive. High prescription costs, out of pocket expenses and high co-pays are some of the factors contributing to the high loss of mental health and substance abuse treatment in the United States.
The cost of mental health treatment
Prescription drugs, residential treatment, and outpatient mental health treatment make up the majority of the costs for mental health treatment while inpatient mental health spending is decreasing dramatically over time. Mental health disorders such as depression, anxiety, schizophrenia, obsessive-compulsive disorder, and bipolar disorder require prescription medications in combination with psychotherapy to provide the best clinical results. Prescription medications are necessary for the treatment of these mental health disorders and depending on the specific type of medication, it can cost an individual anywhere from $15-$1,00 a month, regardless of their insurance coverage. In terms of antidepressants, a 10-milligram capsule of fluoxetine (Prozac) costs $28 a month, whereas a 10-milligram tablet of escitalopram (Lexapro) at retail cost is $87 a month. Fortunately, there is usually a large selection of medications used to treat one specific disorder, and therefore it is crucial to evaluate the cost of these prescriptions when deciding which treatment is right for you.
Psychotherapy on an outpatient basis can cost up to $100 per hour, and many individuals may require anywhere from one to five hours a week. Private insurance and federal funding can cover these costs, but often time there is a deductible or co-pay. Rarely these services are 100% covered by insurance. An intensive mental health care treatment program such as a 30-day residential treatment or partial hospitalization program can cost on average $10,000-$15,000. Most residential and partial hospitalization programs accept private insurance; however, there is usually a deductible that must be paid out of pocket. State and federal mental health programs are generally subsidized; however, an individual must meet their criteria and often there is a long waiting list to enter into one of these treatment programs.
The cost of addiction
Prescription medications, detoxification, outpatient rehab, and inpatient rehab are the most common treatment approaches for substance abuse. Depending on the specific substance, medications can be used to lessen the side effects of withdrawal and prevent future cravings. Opioids or prescription painkillers are known to have severe withdrawal effects, and these withdrawals are a large reason for relapse. Methadone, naltrexone, and buprenorphine are well-known pharmacological treatments used for opioid withdrawal however they have a large range in cost. For example, the price of a 30-day supply of buprenorphine combined with naloxone (Suboxone) can range from $150-$500 depending on the dosage. The average cost of yearlong methadone treatment is approximately $4,700.
Outpatient detoxification usually costs $1,000-$1,500 and can be included in the price for the rehab program. Detox is usually the initial step when entering a substance abuse program and generally takes anywhere from two-five days to eliminate the abused drug from the body. Inpatient rehabilitation substance abuse programs cost anywhere from $6,000-$20,00 on average for a 30-day stay. Outpatient rehabilitation programs are generally less expensive and can cost $5,000-$10,000 for a three-month program. The cost of each rehabilitation program varies on each treatment facility. Insurance can help cover these costs, but that depends on the specific type of coverage an individual carries.
Types of insurance that may cover mental health and substance use treatment
- Medicaid
- Medicare
- Private insurance (PPO)
- Military insurance
- State-financed health insurance