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California mental health stigma-reduction campaign creates economic benefits

April 14, 2016

California's investment in a social marketing campaign to reduce stigma and discrimination associated with mental illness may provide the state with positive economic benefits by increasing employment and worker productivity, according to a new RAND Corporation study.

For every $1 invested in the stigma-reduction effort, the state should receive an estimated $36 through higher tax collections, according to the analysis. Looking more broadly at the state's economy, researchers estimate the stigma-reduction program could generate $1,251 in economic benefits over several decades for every $1 invested.

"We found evidence that the stigma-reduction efforts are reaching California residents who are in psychological distress, and as many as 120,000 may have received services as a result of exposure to these campaigns," said Scott Ashwood, lead author of the study and a policy researcher at RAND, a nonprofit research organization. "We know that when people receive effective treatment they are more likely to be employed and to contribute more to the state's economic well-being.

"So each dollar California invests in this type of effort is projected to return many dollars in dividends through higher personal earnings, improved worker productivity and increased state tax revenue."

"Changing the conversation around mental health stigma has grown into a global movement and this study shows California is at the forefront in breaking down barriers so all Californians can live mentally well," said Wayne Clark, executive director of the California Mental Health Services Authority, which sponsored the study. "This study demonstrates that CalMHSA's programs are effectively targeting Californians with mental health needs, improving help-seeking, and delivering an outstanding return on investment for California. I invite California's leaders to build on the success of these innovative campaigns."

Researchers developed their estimates by analyzing the California Well-Being Survey, which assessed the impact of the state's mental health prevention and early intervention programs on individuals who are experiencing psychological distress. The survey was conducted by RAND in 2014 as part of efforts by the California Mental Health Services Authority (CalMHSA) to create statewide prevention and early intervention programs designed to improve the mental health of California residents.

Researchers surveyed a representative sample of 1,066 California residents who had reported mild to serious psychological distress when they previously took part in the California Health Interview Survey, a statewide survey about a broad array of health issues. The study found that 35 percent of those questioned reported being exposed to the social marketing campaign and those people were more likely to have received mental health treatment over the prior year.

Based on the survey findings, RAND researchers estimated that up to 22 percent more California adults with psychological distress received services for their mental health challenges as a result of their exposure to the stigma reduction social media campaign.

Applying previous research that linked mental health treatment with increased employment and other benefits, the RAND study estimates that about 3,000 additional California adults would become employed as a result of treatment. In addition, researchers estimated that many additional people would be more productive in the workplace because of their mental health treatment.

Researchers say their findings suggest that even if as few as 3,547 adults seek mental health treatment as a result of the sigma-reduction campaign, the state government would break even on its investment in the stigma reduction campaign.

While the study's findings are quite positive, researchers noted that the findings are preliminary. There have been few cost-benefit studies about mental health education efforts so further long-term studies are needed to better understand the impact of such campaigns on treatment-seeking and the well-being of target audiences.

Researchers say there now is good evidence that the investment in the stigma-reduction efforts will return economic benefits for California, but more work is needed to better define how large those benefits can be.

"Our report didn't measure other benefits of stigma reduction, like improved personal relationships and being more productive in one's life outside of work. So we may have underestimated the full benefit of the state's efforts to reduce the stigma of mental health issues," said Rebecca Collins, a co-author of the report and a RAND senior behavioral scientist.

With funds generated by Proposition 63, which imposed a special state tax on people with incomes over $1 million, the efforts supported by CalMHSA are intended to reduce stigma and discrimination surrounding mental illness, prevent suicides, and improve the mental health of students in K-12 schools and colleges across the state. These statewide interventions are being evaluated by RAND, a nonprofit research organization.

The report, "Investment In Social Marketing Campaign to Reduce Stigma and Discrimination Associated With Mental Illness Yields Positive Economic Benefits to California," can be found at

RAND Corporation

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