Trends in the economic burden of mental disorders over twelve years: the Netherlands mental health survey and incidence study.

OBJECTIVE

Mental disorders impose a substantial economic burden, making updated cost estimates essential for informed policymaking. This study provides recent cost-ofillness estimates for mental disorders in the general population and examines trends over a 12-year period.

METHOD: The Netherlands Mental Health Survey and Incidence Study (NEMESIS) is a cohort representative for the Dutch population in which common DSM-IV/DSM-5 mental disorders (mood disorders, anxiety disorders, substance use disorders and attention-deficit/hyperactivity disorder) were diagnosed using the Composite International Diagnostic Interview 3.0. In baseline data of NEMESIS-3 (2019-2022, N=6,194, age 47.9±16.4 years, 50.4% women) we estimated healthcare, productivity, travel costs associated with mental disorders through weighted regression models and compared these estimates with baseline data from NEMESIS-2 (2007-2009; N=6,506, age 44.3±12.5 years, 55.2% women), assuming identical unit prices.

RESULTS

Total annual per capita costs of any mental disorder were €5,630. Productivity costs comprised the largest share of total costs (61%-85%). In all conditions, except substance use disorder, both total annual costs and productivity costs were lower in 2019-2022 compared to 2007-2009. Healthcare costs were substantially lower for mood and substance use disorders in 2019- 2022, even though primary healthcare utilization was increased in 2019-2022.

DISCUSSION: Productivity costs are the primary cost driver of mental disorders. While primary care utilization has increased- possibly due to the introduction of general practice mental health professionals- healthcare resource use has decreased over time. This may indicate a shift in service provision toward primary care from specialized mental healthcare, potentially contributing to more cost-effective mental healthcare delivery.