UNIVERSITY PARK, Pa. — Employees taking days off to handle their mental health problems are costing the U.S. economy billions of dollars in income growth, and that’s expected to continue, according to a new study.

Researchers at Penn State University used economic and demographic data from between 2008 and 2014 to calculate that a single extra mental health day in a month was associated with a 1.84% drop in the per capita income growth rate. That translates to a $53 billion loss nationwide.

“This starts to give us an idea of what the gain could be, if we did spend more money to help people with poor mental health,” argues Stephan Goetz, professor of agricultural and regional economics at PSU, in a release.

For the purposes of the study, poor mental health days were defined as work days that employees miss because of what they describe as mental health issues, citing conditions like depression, anxiety, excessive stress, and emotional problems.

The problem was especially notable for rural counties compared to urban counties, where more resources are likely available to residents and more mental health facilities exist. Researchers calculated a reduction of 2.3% in income growth for a poor mental health day in rural counties, versus a .87% reduction in urban counties.

“We think this difference between urban and rural counties might exist because of the better services that are available for the mentally distressed in the urban counties, which are typically the wealthier counties,” says Goetz, who suggests governments make more mental health resources available to residents to help lower the economic costs of poor mental health.

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But America isn’t the only nation suffering from a mental health nightmare. Within the next two decades, the cost of mental health worldwide should reach $16 trillion — a staggering figure that would trump the cost of any other non-communicable disease, the authors warn.

The study was published June 29, 2018 in the journal The Review of Regional Studies.