Mental Health Care is the Third Highest Medical Expense in U.S.


A study published today in Jama Psychiatry finds that mental health care ties with cancer for the third highest medical expense in the United States, after heart disease and trauma. The study, from Yale, Columbia, the New York Medical College and New York State Psychiatric Institute reports that “While medical professionals at large have begun to consider potential solutions for addressing high costs and low-value care, psychiatrists have been relatively insulated from the discussion for 2 reasons: their infrequent use of the costliest medical procedures and the diffusion of their highest cost factor, psychiatric medications, across a wide number of medical specialists.”

Barkii-Oteo, A., Stern, D., Arbuckle, M.; Addressing the Cost of Health Care From the Front Lines of Psychiatry. Jama Psychiatry. June 2014, 71(6) 619-620. doi:10.1001/jamapsychiatry.2014.121.

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. Is your anti depressant not working ? (just like it doesn’t for most people).

    “Ask your doctor about Abilify”

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    Imagine if the did a study on the effects of Abilify Vs a new Mercedes on a persons depression. If the results are better why not a nice new car ? The cost is the same to the person or their insurance company anyway.

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  2. “In short, the whole business of creating psychiatric categories of ‘disease,’ formalizing them with consensus, and subsequently ascribing diagnostic codes to them, which in turn leads to their use for insurance billing, is nothing but an extended racket furnishing psychiatry a pseudo-scientific aura. The perpetrators are, of course, feeding at the public trough.” —Dr. Thomas Dorman, internist and member of the Royal College of Physicians of the UK, Fellow, Royal College of Physicians of Canada

    “We can manufacture enough diagnostic labels of normal variability of mood and thought that we can continually supply medication to you…But when it comes to manufacturing disease, nobody does it like psychiatry.” —Dr. Stefan Kruszewski, Harvard trained Pennsylvania psychiatrist, 2004

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