The burden of mental disorders includes direct costs, indirect costs, and intangible costs. Direct costs are estimated by the amount of services used and the price of treatment. Indirect costs are estimated by the average reductions in potential future earnings of both patients and caregivers. Intangible costs are those that may be associated with the illness, such as social and family dysfunction, trauma or other problems resulting from the mental disorder.

What is the evidence for burden?

Moderate quality evidence suggests the per person per year direct cost of bipolar-related healthcare is between US$2,500 and US$5,000, and the indirect cost is between US$2,000 and US$11,000.

October 2021

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The burden of schizophrenia includes direct costs, indirect costs, and intangible costs. Direct costs are estimated by the amount of services used and the price of treatment. Indirect costs are estimated by the average reduced future earnings of both patients and caregivers. Intangible costs are those that may be associated with the illness, such as trauma and depression. For the cost of specific treatments, please see the psychosocial and pharmaceutical treatment costs topics.

What is the evidence for the burden of schizophrenia?

Moderate quality evidence finds the overall annual cost of schizophrenia varies worldwide, ranging from US$94 million in Puerto Rico to US$102 billion in the USA (2013; 0.02-1.65% of GDP). Indirect costs associated with productivity loss due to absenteeism, unemployment, or premature mortality contributed 50 to 85% of the overall costs. Hospitalisation accounts for the greatest proportion of direct illness costs.

Relapse costs between US$6,033 and US$32,753 per relapse in the USA, and between US$8,665 and US$18,676 per relapse in Europe and Australia. Re-hospitalisation costs between US$6,383 and US$28,767 in the USA, between US$1,615 and US$39,088 in Europe, Japan and New Zealand, and between US$2,217 and $14,923 in other countries.

Moderate to low quality evidence finds psychosocial burden associated with schizophrenia includes: stigma, marginalisation, discrimination, social withdrawal, disengagement, loneliness, fear, despair, helplessness, problems with relationships and interpersonal skills, frustrations with mental health services, problems with self-esteem and over protection, unmet needs for social reciprocity, constancy, hope and understanding, problems with finding and keeping work, and having a place to live. Facilitating factors to overcome these difficulties are: providing empathetic living spaces, work spaces and routine environments, meaningful occupations and supported employment, exercise for socialisation as well as for health reasons, trust, knowledge in advance of what is happening, training for health workers to listen more and work in partnership and family support.

April 2022

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