Introduction

Abstract

Mental illnesses affect a large portion of every modern society, but until recently, the magnitude and pervasiveness of the problems they cause have been mostly neglected. It is estimated that one in five adults lives with some kind of diagnosable mental disorder. Mental illnesses have significant social and financial burden on society, and account for ~12% of the global burden of disease. In fact, in the USA in 2013, mental illness expenditure surpassed that of any other condition, including heart disease or cancer, to top the list of the most costly health conditions. The global direct and indirect economic cost of mental illnesses is estimated to be around US$2.5 trillion. While direct treatment costs comprise the majority of the economic burden for most diseases, the major economic burden of mental illnesses arises from indirect costs like lost employment and decreased productivity. For instance, while the direct annual cost of mental illnesses in the USA is estimated at US$200 billion, the indirect costs outweigh the direct costs by two to six times. People afflicted with serious mental illnesses lose at least US$190 billion of earnings each year, and they only comprise 20% of cases of mental illnesses annually. Yet, despite the prevalence and the lasting consequences of these diseases, less than half of these patients receive the care they need: 40–45% in developed countries and just 15% in developing countries. Two major barriers in delivering mental health services can be contemplated to explain this huge gap: limited access to care, and inefficient resource allocation.