Clinical Relevance: Mental illness comes with a high personal and economic cost

  • The Los Angeles Dodgers re-signed player Andrew Toles so he can keep his health insurance.
  • Toles was diagnosed with schizophrenia and bipolar disorder.
  • People with mental health conditions like Toles pay a heavy price personally and financially.

A major league baseball team is doing the right thing for the mental health of a player who has not been on the roster for more than five years.

The Los Angeles Dodgers re-signed 30-year-old former outfielder Andrew Toles to ensure he can maintain his health insurance. According to Sports Illustrated, Los Angeles has signed Toles to a contract every year since the 2019 season to guarantee him access to health insurance.

The team won’t pay his salary this season. However, the team said that they still consider Toles a member of the organization.

Toles’ Story

During the 2019 season, a story surfaced that Toles would not report to spring training. Reports said he was dealing with some “personal issues.” The following year, he was arrested and charged with trespassing. He was found homeless, sleeping behind a FedEx building at Key West International Airport. He was taken to a mental health facility after the incident where he was diagnosed with bipolar disorder (BD) and schizophrenia.

The Economic Burden of Schizophrenia

Schizophrenia Risk in Diverse Populations

Neighborhood Vulnerability and Disability in First Episode of Psychosis

High Cost of Mental Illness

The Dodgers have certainly done their part to help Toles by ensuring he continues to have access to professional help. Many people with severe mental disorders aren’t so lucky.

As we’ve recently reported, the average potential life lost for each person with schizophrenia is 28.5 years. Patients with schizophrenic symptoms are at high risk for suicide as well as other medical conditions including heart disease, liver disease, and diabetes. Every person diagnosed with schizophrenia at age 25 carries a total lifetime cost to the economy of approximately $3.8 million. That’s a cost of $92,000 per patient per year.

Bipolar disorder also bears a high economic and personal burden. One analysis estimated the per-person total lifetime costs of BD ranged from $11,720 for a single manic episode to $624,785 for chronic disease. Patients with BD often have numerous other health issues like high blood pressure and drug addiction. Their condition affects their ability to work and care often comes with a huge price tag. 

Fortunately, more people with serious mental conditions are covered by insurance. The national uninsurance rate for adults under age 65 with schizophrenia decreased by 50 percent after the implementation of the Affordable Care Act (ACA) in 2014, according to JAMA Psychiatry research. According to this report, the rate of uninsured people with schizophrenia now stands at around 4 percent.

Where Toles Is Now

The Los Angeles Times reported that Toles is in the care of his father, Alvin, who said his son is in a “zombie-like” condition.

“Schizophrenia, it’s just so tough. I mean, he can’t even watch TV. He hears voices and the TV at the same time, so it’s kind of confusing,” the senior Toles told USA Today in 2021. “I’ve seen him looking at some baseball games on his laptop, but I don’t think he really understands what’s going on. I just want him to have a chance in life. That’s all. Just to be healthy, live a normal life.”