HEA023 Post-traumatic stress disorder/depression treatment leading to increased earnings

Number of participants: Reported by program.

Percentage of participants receiving treatment solely because of program: [54%]. This is estimated by Constellation Fund staff based on data from SAMHSA (2017) which shows that 46% of individuals under 200% of the federal poverty level with any mental illness receive mental health care. Thus, we estimate that about 54% of participants would have not received treatment in the absence of the program.

Percentage of participants who respond to treatment: [60%] We base this estimate on a wide reading of the research literature, including Berndt et al. (2000) and Kazak et al. (2010).

Percentage decrease in earnings prevented as a result of the treatment: [20%], the estimated 20 percent increase in earnings as a result of PTSD treatment is based on the work of Berndt et al. (2000) and Kessler (2000), which shows that PTSD and depression both reduce days worked per month by about 3.6 days, or about 43 days per year, representing about 17 percent of the work year. We round up to 20 percent. This estimate of lost wages is very conservative because it does not consider the more structural aspects of lost opportunity and unstable employment. Moreover, PTSD typically lasts three years for those who get treatment (Kessler, 2000). We do not extend this cost over the lifetime but conservatively apply the cost only to the current year.

Average annual earnings of low-income population: [$8,600 – $24,300], counterfactual earnings calculated from ACS 5-year estimates (U.S Census Bureau, 2016). $8,600 is the average annual earnings of the population in the Twin Cities under 180% of poverty for all earners and non-earners. $24,300 is the average annual earnings for individuals with high school diplomas. The Constellation Fund staff will determine which counterfactual is appropriate for the grantee.

Example: Assuming average annual earnings of $24,300, the value of the lost work time is approximately $3,000 or about 13% of the average annual income. Other researchers have found similar results (Kaya & Chan, 2017; McIntyre, Liauw, & Valerie, 2011). These benefits are already discounted to present value. Note that this effect does not include potential job loss due to illness or as a consequence of work absences.

Kazak, A., Hoagwood, K., Weisz, K., Hood, J.R., Kratochwill, K., Vargas, L.A. & Banez, G.A. (2010). A meta- systems approach to evidence-based practice for children and adolescents. The American Psychologist, 65(2), 85–97.

Kessler, R. C. (2000). Posttraumatic stress disorder: The burden to the individual and to society. Journal of Clinical Psychiatry, 61(5).

U.S. Census Bureau. (2016). American Community Survey 5-year estimates – public use microdata sample, 2012-2016. Generated using Public Use Microdata Area (PUMA) in the Seven-county Twin Cities Metropolitan Area.