Chronic conditions related to poor mental health, along with additional medical expenditures and productivity loss due to mental health challenges, are unevenly distributed across society, resulting in inequities that not only harm individuals but also hinder economic prosperity. Populations with mental health diagnoses face higher rates of chronic illnesses, highlighting the interconnectedness of mental and physical health.

Meanwhile, barriers to receiving care come from a number of factors—all of which have previously created complexities in understanding the full breadth of the cost of mental health inequities. To address this gap in the research, the School of Global Health at Meharry Medical College and the Deloitte Health Equity Institute conducted an equity-focused quantitative analysis to better understand the connection between mental health inequities and costs incurred when they are not addressed.

At the current pace, according to Harvard researchers and the US Office of the Surgeon General, health spending in the United States is expected to grow by an average of 5.4% per year and is estimated to reach a 20% share of the country’s gross domestic product by 2031, compared to the 17.3% share today. To understand the scale of that growth in dollars, we look to previous Deloitte research, which estimated that health inequities accounted for approximately US$320 billion in annual health care spending in 2022 and could grow to US$1 trillion by 2040 if left unaddressed. As such, this report’s analysis underscores the urgent need for an equity-centered approach across government, health care, and business sectors to help mitigate the economic burden created by mental health inequities and the chronic diseases they exacerbate, and to improve overall well-being.

Lower-income individuals bear a disproportionate burden of chronic conditions, exacerbating their economic challenges, while racial and ethnic disparities persist in health care, as this report’s analysis demonstrates. Each of these key issues not only leads to unnecessary health care spending but also contributes to productivity loss, especially among marginalized groups that face higher rates of unemployment due to mental health challenges. According to the World Health Organization, one strategy to address mental health inequities is through integrated care approaches, which can reduce cultural stigma, improve access to mental health services, lower health care costs, and enhance economic stability by ensuring equitable participation in the workforce.

Both common sense and quantifiable trends highlight the importance of addressing mental health immediately:

• About 90% of American adults believe that the country is experiencing a mental health crisis, and their opinions appear to be justified as prescriptions for antidepressants rose 15% between 2015 and 2019 for adults and 38% for adolescents.
• Trends in mental illness and substance use disorders that were worsening prior to the pandemic have escalated since 2020. As of February 2023, over 30% of adults in the United States reported symptoms of anxiety and/or depression, according to a KFF analysis.
• Between 2019 and 2021, deaths caused by drug overdose increased by 50%, according to KFF.
• According to the February 2024 Axios/Ipsos American health index, “Americans see poor mental health as one of the biggest threats to public health.”

Large gaps in mental health and related chronic disease incidence between populations represent major opportunities for leaders to make changes that simultaneously improve productivity, reduce costs, and enhance the quality of life. Taken separately, any one of these improvements could justify the effort and investment necessary to achieve mental health equity. However, the dovetailing of these benefits is what makes this a must-address issue.

To mitigate the worsening impact of poor mental health on our nation, society should address the underlying factors that contribute to these challenges. These include the broader political and social factors that form the fabric of people’s daily lives and shape their opportunities for a healthy lifestyle, along with access to care.