Treating mental health concerns and substance use disorders is a high-value investment that yields tangible returns in healthcare savings, public safety, and economic productivity.
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America’s mental health and substance use crisis isn’t just a public health emergency; it’s becoming one of the nation’s most expensive economic liabilities. The trends are unmistakable: death by suicide among young people has climbed sharply over the past two decades, and deaths linked to drugs, alcohol, and mental health concerns continue to rise across the country.
Utah offers a vivid illustration of how quickly these pressures compound. The state consistently ranks high for mental health challenges, including suicidal ideation, and many residents report ongoing symptoms of anxiety or depression. An urgent part of the story is what happens after someone reaches out for help. In far too many cases, they simply can’t get it.
Nationwide, half of adults with a mental illness went untreated in 2022. In Utah, the gaps are even wider. Many adults and children with diagnosed conditions receive no care at all, and families regularly describe a landscape where services are either unavailable or functionally inaccessible. Parents seeking mental healthcare for their children often run into long waitlists, limited appointment slots, or providers who have stopped accepting new patients altogether.
Clinician shortages create downstream consequences that ripple through households, workplaces, and communities. Average wait times for an appointment stretch more than a month in many parts of the state, and clinician caseloads continue to swell. For people in crisis, these barriers can be catastrophic. For everyone else, they translate into higher costs, more missed work, and worsening health over time.
The high cost of low funding becomes unmistakable when the impacts of effective mental healthcare are measured in socioeconomic terms. To address the longstanding gap between the true value of behavioral health services and the limited funding they receive, the Huntsman Mental Health Institute (HMHI) launched a major research initiative in partnership with the Sorenson Impact Institute (SII) and the Clinical and Translational Science’s Health Economics Core (HEC) at the University of Utah. After a multi-year effort, the team produced a comprehensive report that represents a first-of-its-kind attempt to quantify the social and economic value of an institution’s mental health services using an innovative monetization framework.
“Historically, mental health and economic evaluation have been treated as separate domains,” says Janis Dubno, managing director of impact finance at SII, who directed the project. “Unifying them reveals what has been missing from the conversation, including a clear view of the societal implications tied to untreated mental illness and substance use disorders and the significant returns that come from investing in treatment.” The goal isn’t to reduce mental health to dollars, she emphasizes, but to demonstrate the significant impact these services provide and the value of it in financial terms to inform stakeholders of the benefit they are receiving but not paying for.
A Growing Crisis and an Undervalued Sector
The human toll of the United States’ untreated behavioral health epidemic is well documented. Less appreciated is the economic toll. A recent analysis estimates that untreated mental health conditions cost the U.S. economy $282 billion every year in lost productivity, higher healthcare utilization, and other indirect costs. Throughout the United States, overflowing emergency rooms, overburdened criminal justice systems, and diminished workforce productivity are all expensive symptoms of underinvestment in mental health services. Paradoxically, while mental illnesses impose massive costs on society, the healthcare system has historically underfunded their treatment. Mental health services have long been viewed as a “luxury” or a mere cost center, an area to trim rather than support, in contrast to the robust spending and reimbursement seen in other medical fields.
Why has behavioral health been so persistently undervalued? One reason is structural. The benefits of mental health treatment are diffuse and often accrue outside of traditional healthcare ledgers. For example, if a patient’s depression treatment prevents a costly hospitalization or keeps them employed, those gains might show up as “savings” for an insurance company, an employer, or the tax base and not necessarily as revenue for the mental health clinic that provided care. As a result, providers rarely capture or even quantify the full value they create. A fragmented system of siloed funding streams and inadequate insurance reimbursement perpetuates the gap. These challenges feed a vicious cycle: mental health services are seen as financially unviable, so they remain underfunded, which in turn limits access and worsens outcomes, further reinforcing the perception of mental healthcare as a money pit.
In reality, as mounting evidence shows, treating mental health concerns and substance use disorders is a high-value investment that yields tangible returns in healthcare savings, public safety, and economic productivity. Every dollar not spent on adequate behavioral healthcare today is quite possibly several dollars spent elsewhere in the coming years, whether in emergency room visits, police interventions, incarceration, or lost output in the labor market.
Measuring the Payoff: A New Framework to Value Mental Health
At its core, the framework is designed to show the tangible payoff of mental health treatment: fewer crises reaching emergency rooms, less reliance on police to manage behavioral health episodes, stronger participation in the workforce, and measurable reductions in preventable deaths. By translating patient outcomes into socioeconomic impact that can be quantified, the framework makes visible the returns we typically overlook when mental health is treated as a discretionary expense rather than a core public investment.
The monetization framework functions as a financial lens of the social and economic impact of behavioral healthcare, offering a cross-disciplinary model that connects clinical outcomes to tangible social and economic value and shows clearly who benefits and by how much. For example, HMHI’s Maternal Mental Health program, which supports women with perinatal mood disorders, showed between $2.3 million and $7.4 million in estimated savings over five years, depending on the scenario. About half of that stemmed from reduced healthcare utilization, with the rest from economic output gains and reductions in public assistance use. Likewise, substance use disorder treatment programs at HMHI generated between $5 million and $12.6 million in estimated savings during a five-year time period, driven by lower healthcare use, less criminal justice involvement, and improved productivity.
Even highly specialized programs like HMHI’s Treatment-Resistant Mood Disorders (TRMD) Clinic, which treats the most severe depression cases, showed a positive return. Over the course of a single year, it generated nearly $390,000 in combined healthcare and productivity savings—an encouraging figure, given the high acuity of the patient population. “Even for illnesses that are challenging and expensive to treat,” the report concludes, “effective care pays off.”
Some of the most compelling findings relate to lives saved. Using national benchmarks, the framework estimated that the SafeUT crisis app alone prevented over 32 suicides from 2020 to 2024, translating to millions in future economic value. The 988 Crisis Line, supported in Utah by HMHI, showed similar outcomes related to lives saved. These aren’t abstract projections; they reflect real human impact quantified in terms of societal loss avoided.
As part of the cross-disciplinary collaboration, Dr. Fernando Wilson, director of the HEC, estimated the costs avoided through reduced emergency department visits and psychiatric hospitalizations. He calculated that the overall mean cost of an avoided ED visit from UHealth EHR data is $496.83 per visit. “These findings provide evidence that HMHI programs are very effective in keeping patients out of high-cost medical settings, creating an important positive externality for the larger healthcare system,” Dr. Wilson noted.
The HMHI monetization report team acknowledges its limitations, including the lack of available data and the challenges of attributing causality. Yet it still advances a more complete account of behavioral health’s value in a language that decision-makers understand. And in doing so, it reframes a cost problem as an investment opportunity that can yield socioeconomic returns that are central to a healthy, functioning society.
Underfunding mental health simply shifts the bill to more expensive systems down the line, such as EDs, law enforcement, and the labor market. Viewing mental healthcare as an investment instead of an expense changes the equation, redirecting resources toward interventions that reduce those burdens and generate measurable value for individuals and the entire community.