Original title: Adolescent Mental Healthcare as a Public Utility: A Multi-Sectoral Economic Case for Proactive Investment
Mackenzie Swirbul, Emily Peake, Anne Bischops, Marie-Laure Charpignon +2 · September 2026
Most psychiatric disorders start during adolescence, a key time when the brain easily adapts and grows. Yet, the US mental healthcare system usually reacts to crises instead of stepping in early. This reactive approach leaves nearly half of symptomatic youth untreated. It also creates a massive economic burden from lost productivity and higher healthcare spending. Researchers reviewed studies across schools, the legal system, jobs, and healthcare. They wanted to understand how treating mental health like a public utility—an essential public service everyone needs—would help society. Untreated conditions cause high-cost emergency care, chronic school absenteeism, juvenile justice involvement, and lower caregiver work productivity. Investing early in accessible youth mental healthcare provides real socioeconomic returns, making it both a fiscal and public health priority.
Imagine a town that only fixes potholes after cars are damaged, rather than maintaining roads regularly. This reactive approach ends up costing more in repairs and lost time. Here, the paper argues that treating teen mental health only after a crisis is like fixing potholes after accidents—proactive maintenance would save money across schools, courts, and hospitals.
Nearly half of symptomatic US teens get no mental health care, leading to costly crises later. This paper shows that proactive treatment could reduce spending on special education, juvenile detention, and emergency healthcare while boosting caregiver productivity. Policymakers have a fiscal argument to invest early.
This is a narrative review, not an original study. It synthesizes existing evidence but does not present new data or specific ROI calculations. The focus is on US policy, so findings may not generalize to other countries. It does not address potential challenges in implementing proactive care, such as workforce shortages or funding mechanisms.
Ask anything about this paper. Answers come from its abstract, and say so when the abstract doesn't cover your question.
Adolescent Mental Healthcare as a Public Utility: A Multi-Sectoral Economic Case for Proactive Investment — Mackenzie Swirbul, Emily Peake, Anne Bischops et al. — PsyArXiv — doi:10.31234/osf.io/qm8sz_v1
Abstract licence: CC BY
Explanation generated by Synthesis from the abstract — it is not the original paper. This is a preprint, so it hasn't necessarily been peer reviewed.