I write about personal finance often. I get honest about my current money situation and financial fitness, and I open up about my past money mistakes with the hope that others can learn from where I’ve gone wrong.
But there’s nothing harder than talking about the least-discussed element of the story: how mental health disorders have affected our money.
One in five adults face mental illness every year, the National Institute of Mental Health (NIMH) reports. A further one in 25 has severe enough disorders to interrupt day-to-day functioning. These mental health disorders cost $193.2 billion in lost wages a year.
The Cost of Mental Illness for Our Family
About four years ago, my husband was diagnosed with bipolar II disorder. Of course, there was a lead-up to him seeking help that’s too long and personal to go into. But receiving this diagnosis felt both relieving and terrifying.
Almost instantly, we were thrust into a world of medications, therapies, relaxation programs, holistic remedies, and more.
We had no idea what we were getting into. All we wanted was for my husband to feel “normal” again. Or at least, as “normal” as he could feel with a diagnosed mental health disorder.
We were willing to try everything and anything thrown our way. And with every new doctor, therapist, and drug, we paid the price.
How much? Well, it’s complicated. A typical month for us with our employer-sponsored insurance looks a bit like this:
- $200 to $250 for multiple weekly therapy copays
- $50 for bimonthly psychiatric care copays
- $20 for medications covered by insurance
- $5 for a meditation app
- $15 for vitamins recommended by doctors
That comes to a total of $290 to $340 per month at a minimum. There have been times when we had to pay more for extra therapy sessions or wanted to try a gym pass, yoga classes, or therapeutic treatment — all related to his mental health.
Dealing With Emergencies
And then there’s the other side of the coin: when mental health decides to go haywire. As in any other medical emergency, there are sometimes signs this is about to happen. But in most cases, it comes out of the blue.
For example, as we moved to our new home in Philadelphia, my husband began to react negatively to a medication he’d been using for a year. The situation escalated, and we wound up racing to find any doctor who could see him as his condition rapidly deteriorated. But every doctor’s appointment book was filled for three to four months in advance.
So my husband’s only choice? Visit the emergency room. There, he could see a psychiatrist and be placed on a transitioning drug to tide him over until he could see his new doctor. The total out-of-pocket cost for a 20-minute ER and hospital visit was nearly $750. Ouch.
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No Shortcuts
For most personal finance stories, this is the point in the article when I write how we have saved money doing X or how you could prevent crises from costing you a fortune by doing Y. Unfortunately, I have nothing to offer you.
Sure, there are ways you can save on vitamins (clip coupons and buy generic) — or even on your therapist (ask for a sliding-scale payment if you are under- or uninsured).
But the brutal, heartbreaking truth is that there’s no easy answer when it comes to a major mental health disorder.
The reality of mental illness is that there are no cheap options. But without inexpensive, readily available care, our country continues to face a financial crisis that we urgently need to address.
“Diet, supplements like vitamins, and exercise can be extremely helpful in treating most mental health disorders on a daily basis,” says Rabbi Shlomo Slatkin, a certified therapist, “but if someone has a major disorder, they do need to get help.”
At my home, we treat bipolar disorder like any other chronic illness. You take medication, make schedules with doctors, and lay out emergency plans. We also try to have a healthy outlook on what the reality of the disorder is and can be.
Using Disability Insurance to Protect Yourself
New jobs can mean signing up for short- and long-term disability coverage if your company offers it. Short-term disability coverage is designed to provide a financial safety net if you are incapacitated and unable to work — generally a few months. This coverage will reimburse you a percentage of your salary for an average of 13 to 26 weeks.
Long-term disability (LTD) can last for years, depending on the policy. Specifically, LTD for mental illness can vary widely among insurers in both coverage and cost. These policies are also less likely to be covered by your job.
As some short-term disability coverage does not cover mental illness at all, be sure to request a copy of your employer’s policy to understand the benefits you are buying into.
Short- and long-term disability insurance can be financial lifesavers if you ever need to leave work for reasons related to mental health.
We spoke with insurance planning professional Andrew Stewart of AMS Resources Network, a financial services firm, to discuss what coverage you can expect, and what price you can expect to pay.
Know Your Rider
“As a base policy feature, most disability insurance — short and long term — does not have coverage for mental health,” Stewart says. “However it is relatively inexpensive to add the coverage — through a rider — to a long-term policy.”
“If you elect to add the rider, depending on the carrier you choose, you can be granted limited benefits or full benefits for disability caused by mental illness,” Stewart continues.
The Price Is Right
“Coverage costs for long-term disability vary wildly based on the amount of income you choose to replace, how long you want the benefits to last — anywhere from six months to until retirement age — and the length of the waiting period before benefits begin.
“For example, a healthy 30-year-old working a typical office job replacing $3,000 a month in income with a benefit period to last until age 67 and a 90-day waiting period with mental illness coverage added will pay $58 a month in premium.”
Short Term, Cheap Term
“Short-term disability is only offered through employee benefits and usually does not offer benefits for mental illness, but is often inexpensive. It can cost as little as $5 per pay period and replace most of your lost income.”
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Managing the Cost of Mental Illness: The Bottom Line
We’ve found that keeping notes on doctors and hospitals where he could go for inpatient services can be helpful. In case we need to refer to it, we have dates, names, and amounts. I can’t emphasize how important organization is.
We plan for the unplannable and hope that it never happens. And we — like many of the millions of Americans diagnosed with mood disorders — understand that the best way to fight the cost of mental illness is to receive optimal, professional medical care, regardless of the cost. Without treatment, you risk losing more than just your money.
Additional reporting by Connor Beckett McInerney.
