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Author: Frank, Richard G.

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1.	Frank, Richard G. Glied, Sherry A.
1.	America's Continuing Struggle with Mental Illnesses: Economic Considerations Journal of Economic Perspectives 37, 2 (2023): 153-178. Also: https://www.jstor.org/stable/27211438 Cohort(s): NLSY79 Publisher: American Economic Association Keyword(s): Cost, Healthcare ; Health Care; Health, Mental/Psychological; Illnesses, Mental Permission to reprint the abstract has not been received from the publisher. Mental illnesses affect roughly 20 percent of the US population. Like other health conditions, mental illnesses impose costs on individuals; they also generate costs that extend to family members and the larger society. Care for mental illnesses has evolved quite differently from the rest of health care sector. While medical care in general has seen major advances in the technology of treatment this has not been the case to the same extent for the treatment of mental illnesses. Relative to other illnesses, the cost of care for mental illnesses has grown more slowly and the social cost of illness has grown more rapidly. In this essay we offer evidence about the forces underpinning these patterns and emphasize the challenges stemming from the heterogeneity of mental illnesses. We examine institutions and rationing mechanisms that affect the ability to make appropriate matches between clinical problems and treatments. We conclude with a review of implications for policy and economic research.
	Bibliography Citation Frank, Richard G. and Sherry A. Glied. "America's Continuing Struggle with Mental Illnesses: Economic Considerations." Journal of Economic Perspectives 37, 2 (2023): 153-178.

2.	Frank, Richard G. Meara, Ellen
2.	The Effect of Maternal Depression and Substance Abuse on Child Human Capital Development NBER Working Paper No. 15314, National Bureau of Economic Research, September 2009 Cohort(s): Children of the NLSY79 Publisher: National Bureau of Economic Research (NBER) Keyword(s): Adolescent Behavior; Alcohol Use; Behavior Problems Index (BPI); CESD (Depression Scale); Child Self-Administered Supplement (CSAS); Children, Academic Development; Children, Behavioral Development; Delinquency/Gang Activity; Depression (see also CESD); Drug Use; Home Observation for Measurement of Environment (HOME); Modeling, Fixed Effects; Mothers, Behavior; Peabody Individual Achievement Test (PIAT- Math); Peabody Individual Achievement Test (PIAT- Reading); Propensity Scores; Siblings Also presented: Boston, MA, Health Economics Seminar, March 2009, and at the University of Lausanne, 2009. Recent models of human capital formation represent a synthesis of the human capital approach and a life cycle view of human development that is grounded in neuroscience (Heckman 2007). This model of human development, the stability of the home and parental mental health can have notable impacts on skill development in children that may affect the stock of human capital in adults (Knudsen, Heckman et al. 2006; Heckman 2007). We study effects of maternal depression and substance abuse on children born to mothers in the initial cohort of the 1979 National Longitudinal Survey of Youth (NLSY), a national household survey of high school students aged 14-22 in 1979. We follow 1587 children aged 1-5 in 1987, observing them throughout childhood and into high school. We employ a variety of methods to identify the effect of maternal depression and substance abuse on child behavioral, cognitive, and educational related outcomes. We find no evidence that maternal symptoms of depression affect contemporaneous cognitive scores in children. However, maternal depression symptoms have a moderately large effect on child behavioral problems. These findings suggest that the social benefits of effective behavioral health interventions may be understated. Based on evidence linking early life outcomes to later well-being, efforts to prevent and/or treat mental and addictive disorders in mothers and other women of childbearing age have the potential to improve outcomes of their children not only early in life, but throughout the life cycle.
	Bibliography Citation Frank, Richard G. and Ellen Meara. "The Effect of Maternal Depression and Substance Abuse on Child Human Capital Development." NBER Working Paper No. 15314, National Bureau of Economic Research, September 2009.

3.	Frank, Richard G. Meara, Ellen
3.	The Impact of Maternal Depression and Substance Abuse on Cognitive, Behavioral, and Educational Outcomes of Children Presented: Washington, DC, AcademyHealth Research Conference, June 9-10, 2008 Cohort(s): Children of the NLSY79 Publisher: AcademyHealth Keyword(s): Adolescent Behavior; Alcohol Use; Behavior Problems Index (BPI); CESD (Depression Scale); Child Self-Administered Supplement (CSAS); Children, Academic Development; Children, Behavioral Development; Delinquency/Gang Activity; Depression (see also CESD); Drug Use; Grandparents; Home Observation for Measurement of Environment (HOME); Modeling, Fixed Effects; Mothers, Behavior; Peabody Individual Achievement Test (PIAT- Math); Peabody Individual Achievement Test (PIAT- Reading); School Suspension/Expulsion; Variables, Instrumental Permission to reprint the abstract has not been received from the publisher. Study Design: We use instrumental variables models (IV) to estimate causal links between maternal behavioral health (symptoms of depression, evidence of alcohol abuse or dependence, and heavy use of marijuana) and measures of cognitive, behavioral, and educational outcomes in children (age-standardized test scores in math and reading, behavioral problems, measures of delinquency, expulsion, grade repetition, and completion of high school by age 18). Specifically, we use information on the mental health status and alcoholism of maternal grandparents and the presence of symptoms of mental and addictive disorders early in a mother's life as instruments for depression and substance abuse in motherhood in models of child outcomes described above. Our models of child outcomes also control for maternal demographics and household characteristics. Population Studied: Two cohorts of children born to mothers in the initial cohort of the 1979 National Longitudinal Survey of Youth (NLSY), a national household survey of high school students aged 14-22 in 1979. We follow 3,228 children aged 1-5 in 1987 and 2,737 children aged 1-5 in 1992, observing them through age 18-22 (Cohort 1) and 13-17 (Cohort 2).
	Bibliography Citation Frank, Richard G. and Ellen Meara. "The Impact of Maternal Depression and Substance Abuse on Cognitive, Behavioral, and Educational Outcomes of Children." Presented: Washington, DC, AcademyHealth Research Conference, June 9-10, 2008.

4.	Wang, Buyi Frank, Richard G. Glied, Sherry A.
4.	Lasting Scars: The Impact of Depression in Early Adulthood on Subsequent Labor Market Outcomes NBER Working Paper No. 30776, National Bureau of Economic Research, December 2022. Also: https://www.nber.org/papers/w30776 Cohort(s): NLSY79 Publisher: National Bureau of Economic Research (NBER) Keyword(s): Depression (see also CESD); Labor Market Outcomes; Occupational Information Network (O*NET) A growing body of evidence indicates that poor health early in life can leave lasting scars on adult health and economic outcomes. While much of this literature focuses on childhood experiences, mechanisms generating these lasting effects--recurrence of illness and interruption of human capital accumulation--are not limited to childhood. In this study, we examine how an episode of depression experienced in early adulthood affects subsequent labor market outcomes. We find that, at age 50, people who had met diagnostic criteria for depression when surveyed at ages 27-35 earn 10% lower hourly wages (conditional on occupation) and work 120-180 fewer hours annually, together generating 24% lower annual wage incomes. A portion of this income penalty (21-39%) occurs because depression is often a chronic condition, recurring later in life. But a substantial share (25-55%) occurs because depression in early adulthood disrupts human capital accumulation, by reducing work experience and by influencing selection into occupations with skill distributions that offer lower potential for wage growth. These lingering effects of early depression reinforce the importance of early and multifaceted intervention to address depression and its follow-on effects in the workplace.
	Bibliography Citation Wang, Buyi, Richard G. Frank and Sherry A. Glied. "Lasting Scars: The Impact of Depression in Early Adulthood on Subsequent Labor Market Outcomes." NBER Working Paper No. 30776, National Bureau of Economic Research, December 2022.

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