Harvard Mental Health Letter

In Brief: Survey finds that mental illness affects the wallet as well as the brain

A survey of people living in 19 countries, including the United States, has found that those diagnosed with a serious mental illness earned an average of one-third less money in a given year than other people.

Researchers at Harvard Medical School collaborated on the study with staff at the World Health Organization (WHO). Lay interviewers first administered the WHO World Mental Health Survey in person with 101,825 individuals. The interviewers asked a series of structured questions based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to identify people with specific types of psychiatric disorders. These included anxiety disorders (generalized anxiety disorder, panic disorder, phobias, post-traumatic stress disorder), mood disorders (major depressive disorder, dysthymic disorder, and bipolar disorder), and alcohol and substance abuse disorders. The researchers specifically excluded severe and persistent psychiatric disorders that were likely to cause long-term disability, such as schizophrenia, because they wanted to examine the impact of mental illness on people who were able to work but might need to take time off because of exacerbations in illness.

The researchers identified a subset of people who met criteria for having a serious mental illness and compared their average earnings with those of healthy workers in each country. They estimated that people with serious mental illness living in high-income countries, such as the United States, France, and Germany, earned, on average, 32% less than the median earnings of other workers. People with serious mental illness living in low- to medium-income countries, such as Brazil, India, and China, earned on average 33% less than median wages.

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