Economists have given little attention to the social construction of illness and how it undergirds cost-of-illness estimates. Social construction captures the prevailing conceptions of normative behavior. This article focuses on three of the most influential conceptions: the stigmatization of mental illness and those who have a mental illness; the punitive attitudes that society holds towards those whose behavior is deemed deviant; and the linkage of mental illness with productivity. The cost of mental illness is a product of the social norms embedded in the socialization of the illness and the science underpinning the estimate.