CounselorsEmpowerACA Government Affairs Blog

The ACA Government Affairs team strives to keep the counseling community connected with important legislative news, updates, and announcements that affect the profession. Questions? Want to get involved in our advocacy efforts? Email us at 


Dec 12, 2018

The Costs of Mental Illness In Treating Physical Illness

The effects of mental health on physical health are well known. An Oxford University review of the literature shows that the average reduction in life expectancy is between seven to eleven years for someone with recurrent depression, nine to twenty years for someone with bipolar disorder, ten to twenty for schizophrenia and nine to twenty-four years for drug and alcohol abuse. As a comparison, the decline in life expectancy for heavy smokers is eight to ten years.

The causes vary in each case, but one common factor is the tendency to separate mental and physical illness, explains Dr. Seena Fazel of Oxford. “Many causes of mental health problems also have physical consequences, and mental illness worsens the prognosis of a range of physical illnesses, especially heart disease, diabetes and cancer. Unfortunately, people with serious mental illnesses may not access healthcare effectively,” says Dr Fazel. They fail to get routine checkups or take preventative steps that can keep them healthy. In some cases their mental illness keeps them from having the insurance that would cover the costs of the care they need. 

Depression and Back Pain

A new study from the University of Arizona College of Medicine takes the mental health-physical health relationship a step further by showing that healthcare costs for a physical ailment are higher when accompanied by depression. The Arizona study looked at nearly 73,000 people to see who reported having painful back problems and who among those also had a diagnosis of depression.

The research team found that “back pain patients with depression had about $13,000 in total health care expenses per year, as compared to $7,500 for those without depression.” According to the study’s lead author, Dr. Jawad Bilal, “We also know that depression can increase the sensation of pain. Those with depression may need to use inpatient and outpatient services more.”

The relationship between back pain, depression, and higher healthcare costs is one more data point in the rationale for allowing licensed professional counselors to bill Medicare for their services. The American Counseling Association has been building this case in Congress and we thank all the ACA members who have contacted their legislators on this issue.

January will bring a new Congress and new opportunities to pass Medicare legislation that will benefit counselors and their patients. ACA’s government affairs team is working with our Congressional sponsors to have bills reintroduced in the House and Senate as early as possible next year. When that happens we will again ask ACA members to help us build support in Congress.

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1 Comment

  1. 1 Jenna 09 Feb
    For the record - constant and significant pain can also lead to depression. Depression doesn’t necessarily come first nor make the pain worse. We must be careful how we set up and/or report studies like this not to blame patients for their pain because they are depressed. Regardless, patients suffering still can use the help of knowledgeable, well-educated and compassionate counselors.


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