Essays In The Economics Of Mental Health

Essays on the Economics of Mental Health and Well-being

Essays in the Economics of Mental Health

One in five adults in the United States experiences mental illness in a typical year. Less than half get treatment. The novel coronavirus pandemic has increased mental health pressures above that baseline. This dissertation addresses the intersection between mental health and economic issues building upon two important findings: (1) the economic finding of a bidirectional causal relationship between mental health and economic outcomes and (2) the psychiatric finding that mental-wellness-focused smartphone applications (apps) are effective. Mental wellness apps are low-cost, scalable, and pandemic-appropriate, but current use is limited. Given the relationship between mental health and economic outcomes and the efficacy of mental wellness apps, can we leverage mental wellness apps to improve economic outcomes? The first two chapters of this dissertation report on my randomized controlled trials testing strategies to expand usage of mental wellness apps. First, I find providing mental-wellness-app privacy ratings increases selection of privacy-preferred apps by six percentage points among likely app users, a significant shift that could drive competitive pressures toward improved privacy protections. Likely app users care about this issue and are willing to pay one third of the average monthly app price to access the ratings, suggesting $80 million in social welfare gains from implementing privacy ratings nationally. Second, among individuals willing to download apps, I find offering $3 for downloading, installing, and using a mental wellness app for two weeks does not have significant mental wellbeing or work productivity impacts on my sample as a whole. Instead, high-productivity individuals see productivity increases of 0.127 standard deviations, worth $20 per high-productivity participant over the measured second week of treatment. However, low-productivity participants experience no change or negative changes in productivity as a result of the intervention. Taken together, these findings suggest further research is necessary to clarify the conditions under which workplace use of mental wellness apps is beneficial before broadly implementing similar incentive schemes. Third, I investigate the presence and impacts of gender-identity-related social stigma on health and work outcomes using Behavioral Risk Factor Surveillance System (BRFSS) data maintained by the U.S. Centers for Disease Control and Prevention (CDC). I find transgender status is associated with poorer mental and physical health and controlling for mental and physical health status and demographic characteristics, transgender Americans experience poorer work outcomes than similarly situated cisgender (that is, not transgender) Americans, by about $10,000 per year. This outcome is not the result of using stigmatized health behaviors, as after controlling for adverse childhood experiences, transgender people use no more stigmatized health behaviors than their cisgender peers. Mental wellbeing is a key component of individual and social welfare and human capital. This dissertation investigates the intersection between mental health and economics, a promising and important area for economic research.

Essays on Economics & Political Economy

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