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Statistics relating to workplace psychiatric illness claims underline just how commonly psychiatric disorders and their associated problems burden individuals, employers, and society as a whole. Large numbers of individuals either enter the workplace with preexisting psychiatric disorders or develop psychiatric disorders during the course of their working lives. Depending on the study reviewed, between 20 and 25% of adults of working age suffer from a diagnosable psychiatric disorder in any given year. The Surgeon General’s Report on Mental Health (United States Department of Health and Human Services, 1999) estimated that about one in five Americans experiences a psychiatric disorder in a given year. The National Institute ofMental Health has estimated that 26.2% of Americans aged 18 and older, about one in four adults suffer from a diagnosable psychiatric disorder in a given year (National Institute of Mental Health, 2007). When applied to the 2004 United States Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people (National Institute of Mental Health, 2007).

Statistical analyses have also found that large numbers of individual with psychiatric illness are employed. One study found that of individuals with any psychiatric illness, 48–73% are employed; 32–61% of individuals with serious psychiatric illness are employed. Of all adults, 76–87% are employed (Jans, Stoddard, & Kraus, 2004). In 2005, an estimated 29% of individuals (or 2,185,000 people) between the ages of 21 and 64 who reported having a mental disability were employed (Cornell University Disability Statistics, 2005). The monetary costs of psychiatric disorder and disability due to psychiatric disorder are staggering. Annual income in those with psychiatric illness who work is reduced due to psychiatric illness between $3500 and $6000 on an individual basis, and between $100 and $170 billion collectively every year (Marcotte & Wilcox-Gok, 2001). The first national estimate of lost earnings associated with mental disorders in the United States was $44.1 billion in 1985 (Rice, Kelman, Miller, & Dunmeyer, 1990). Costs of reduced or lost productivity in 1990 were estimated to total $78.5 billion, including both lost earnings and productivity (Jans et al., 2004). In 1992, this estimate was updated to a loss of $77 billion (Harwood et al., 2000). The most recent estimate, for the year 2002, is $193.2 billion. Of this, 75.4% was due to reduced earnings among mentally ill persons with any earnings and the remaining 24.6% was due to reduced probability of having any earnings (Kessler et al., 2008). Comparative cost of illness studies have demonstrated that the magnitude of this association is high in relation to most physical disorders.

We dedicate this book to our friend and mentor, Robert I. Simon, MD.