What makes people miserable? Traditionally, economists have pointed to unemployment and poverty as the biggest drivers of despair. But new research suggests such analysis is flawed.
“We keep on finding in every country that the mental health problems are the biggest causes of misery,” says Richard Layard of the London School of Economics, who along with colleague Sarah Flèche analyzed happiness and satisfaction surveys from around the world. In a paper published in January in the journal Kyklos, Flèche and Layard found that the correlation between mental illness and misery was strong even when poverty and unemployment were controlled for. In other words, it isn’t just that people have mental health troubles only because they face deprivation; mental problems do a great deal to cause unhappiness regardless of whether somebody has a job and makes a decent living, Layard says.
The finding may seem obvious, but non-physical ailments were in the past ignored as economists tended to focus on external factors, and it was widely thought that not much could be done to treat mental health problems, says David Clark, a professor of experimental psychology at the University of Oxford.
The findings are consistent with work done by Clark and Layard in Britain showing that mental illness takes a bigger toll on productivity than physical health problems. They calculated that if these mental health issues were treated, it would increase the GDP by four percent.
Over the last decade, these scholars and others have lobbied the government to treat mental health as aggressively as physical problems, and have succeeded in prodding the British government to start a program that now treats 550,000 people per year with evidence-based psychological and psychiatric treatments, Clark says.
Youth and young adults are particularly vulnerable to mental illness. “We have a success-oriented culture [that] puts a lot of strain on young people,” Layard says. At least 10 percent of those ages 5 to 18 in the United States and Britain are diagnosable with mental illness, he says. But most of these people, around three-fourths, are not being treated.
“It is quite a scandal, I think, that in most Western countries and the U.S., the majority of people just don’t get access to the latest evidence-based psychological treatments,” Clark says.
This doesn’t necessarily suggest that drugs should be more widely prescribed. In many cases, psychological and behavioral treatments work as well or better, without side effects, and people prefer psychological therapies over drugs by a factor of three-to-one, Layard says. However, many more people get drugs and no psychological intervention. One reason for this is the pressure brought to bear by pharmaceutical companies.
Regardless of the treatment method, mental health problems are best dealt with when caught early, and these problems need to be treated as quickly and aggressively as physical ailments, Clark says. The United States and Britain have made strides in this area in the past two decades, with each now spending about one percent of GDP on mental health treatment, though there is room for improvement.
For these issues to be treated early and quickly, it’s vital for people to have health insurance, making the findings relevant in the context of President Donald Trump’s avowed plan to roll back the American Care Act. “The idea that you have an extra 20 million people [who] might no longer be insured...does seem very terrible,” Clark says.