[Analysis of avoided costs by supported employment for people with mental disorders]

Introduction Supported employment, financed by the French Government since 2016, has demonstrated its positive impact on employment access and retention for people declaring a mental health disorder (40% of people supported in 2022). Objective The objective of the analysis of avoided costs, led by the Agence nouvelle des solidarités actives (Ansa) in 2021 and 2022, was to measure the economic impact of supported employment on public finances. This analysis focused on three types of costs: social benefits, psychiatric hospitalizations, and medical leave. Method The method consisted of collecting information from supported employment clients to compare these costs over three years (the year before supported employment and the following 2 years). In total, 462 people responded to the questionnaire, including 136 people over 2 consecutive years. These 2 samples were representative of the entire population of supported employment clients (9,300 people at the end of 2022). Results This analysis demonstrates significant avoided costs with, on average, a saving of 802 euros per person during the first year and 1,213 euros per person during the second year of supported employment. If we extrapolate to the total number of clients at the end of 2023, this constitutes a saving of 7.3 million euros for the year 2022 alone and this only on the 3 types of costs observed. The largest part of avoided costs can be attributed to a significant drop in the cost of psychiatric hospitalizations (-56% over 2 years) and in the cost of social benefits (-8.5% over two years). This analysis also demonstrates that the avoided costs are greater for people declaring a mental health disorder (average avoided cost amounts around 2,200 euros per year). This difference is largely explained by the drop in the number of psychiatric hospitalizations, whether as a percentage of people hospitalized (from 18% the year preceding entry to 9% and 12% over the following 2 years) and by the reduction in the average number of days of hospitalization (from 31 days in the year preceding entry to 20 days in subsequent years). For this public, we also see a slight decrease in the cost of medical leave (-16% over 2 years). Conclusion From a purely economic point of view, this analysis demonstrates a greater impact of supported employment for people suffering from mental health disorders and the need to strengthen links with mental health professionals to orient people towards supported employment.