A look ahead suggests that reductions in deaths from heart conditions and cerebrovascular disease are likely to drive spending on mental disorders even higher, as more people survive to older ageswhen mental disorders, such as dementia, become more prevalent. (So I'm guessing it's dementia included in 'mental disorders' institutionalized which explains why that seems so high.) http://content.healthaffairs.org/content/early/2016/05/13/hlthaff.2015.1659.full "People Who experience mood swings, fear, voices and visions"