The Social Returns to Mental Health Care: Evidence From a Dutch Health Insurance Reform
AbstractOn January 1, 2012, the Dutch government raised the out-of-pocket cost for specialist mental health services (SMHS) by €200. Subsequently, the annual number of patients in treatment declined sharply and persistently by 95,000, or 16.4 percent. Our project uses this reform and detailed administrative data to estimate the effect of SMHS use on a wide variety of indicators of social functioning.
In this presentation, we present preliminary estimates of the effect of continuing treatment on employment for individuals who are in SMHS treatment and face the decision of whether to continue or to stop treatment. Our identification strategy relies on the timing of when these individuals started their SMHS treatment before the reform, which unexpectedly determined the out-of-pocket cost they faced to continue treatment. Using this variation in out-of-pocket cost as an instrumental variable, we find a strong positive effect of continuing SMSH treatment on employment.