Mental health and lost income: It costs South Africa more to not treat mental illness than to treat it

10 Oct 2012 - 12:00

On the brink of World Mental Health Day (10 October), new findings from a research study in South Africa  show that people living with mental illness lose substantial income due to the disability and stigma that they face. This has important implications for public health policymakers in low-and middle-income countries, as it reveals that government’s investment in mental health care for the public can translate into economic benefits, and reduce the societal costs of mental illness.

Based on the first nationally representative sample of mentally ill in South Africa, a recently published research study by Prof Crick Lund and colleagues at the University of Cape Town showed that the total annual cost in lost earnings for South Africans with mental disorders was in the region of R30 billion ($3.6 billion). This is in stark contrast to government’s projected total annual expenditure on mental health services of around R500 million ($59.3 million). “The findings support the argument that it costs South African society more to not treat mental illness than to treat it” said Prof Lund. The researchers expect the cost of lost earnings due to mental illness to be higher as their analysis excluded child and adolescent mental disorders, and other severe chronic mental disorders such as schizophrenia and bipolar mood disorder. The researchers suggest that there is a strong economic argument for preventing mental illness and scaling up mental health care and rehabilitation services, as a means for alleviating the economic burden of these diseases.

One research programme (PRogramme for Improving Mental health carE, PRIME) funded by UKAID’s Department for International Development (DFID) is developing evidence on the best ways to scale up mental health services. In so doing, PRIME hopes to advise low-and middle-income country governments on the best ways to integrate mental health care into the existing primary health care systems, and how to maximise the use of existing resources through simple ideas such as ‘task-shifting’. 

PRIME Research Director Vikram Patel speaking on task-shifting at a TED Talk

However, an important first step towards this goal is for governments to develop the political will, and make more financial resources available for mental health care. And it even makes economic sense. For more information about PRIME, visit


[1] Lund, C. Myer, L. Stein, D. Williams, D. Flisher, A (2012). Mental illness and lost income amongst adult South Africans. Social Psychiatry and Psychiatric Epidemiology. Available