Abstract
Cost or burden of illness studies for mental illnesses has helped define the magnitude of their negative effects on the household, community and national economy. Despite its many benefits, there is a paucity of these studies among Nigerians being managed for mental illnesses. This study was aimed at assessing the economic burden of mental illnesses and its effect on household purchasing power. The study was descriptive cross-sectional in design conducted among 284 out-patients with five categories of mental illnesses at the Neuropsychiatric Hospital, Aro recruited via a systematic sampling technique. Data collection was quantitative using a semi-structured interviewer-administered tool. Participants provided the actual direct costs and estimates of indirect costs incurred during their most recent inpatient admission and their first clinic visit after discharge. Parametric and non-parametric statistical tests were conducted on the direct and estimated indirect costs respectively after testing them for normality using the Q-Q plot with statistical significance determined at p<0.05. Almost 96% of respondents finance their healthcare costs by themselves or their family with >50% earning <US$1.8 per day. Their mean direct and estimated indirect costs were (US$23.1±US$11.3 and US$15±US$28). There were no statistically significant differences in the mean direct and estimated indirect costs incurred by participants across the categories of mental illnesses. A significantly higher proportion of participants could afford the essential goods (88%) compared to those who could afford luxurious goods (29%) with p<0.001. The mean direct costs incurred by those who could afford the essential and luxurious goods were significantly higher than those who could not following a t-test. The median estimated indirect costs incurred by those who could not afford luxurious goods differed significantly from those who could with the Mann Whitney U-test. Participants with mental illnesses face a high economic burden in managing their condition with the majority unable to afford luxurious goods. Affordability was also associated with incurring more direct costs.
Highlights
Cost of illness or burden of illness studies measure the prevalence of diseases, the effects on longevity and quality of life as well as the direct and indirect financial implications of the disease on individuals, their households, the community and national economy at large [1]
It is important to note that schizophrenia and other severe mental illnesses were more represented in the study, accounting for about 70% of cases, this is similar to other studies conducted in referral Centres in Nigeria [18] and other developing countries [19, 20]
This study showed that the estimated indirect cost of mental illnesses was high, especially for those respondents who lost their job as a result of the illness and had to depend on family members for most things including hospital bills
Summary
Cost of illness or burden of illness studies measure the prevalence of diseases, the effects on longevity and quality of life as well as the direct and indirect financial implications of the disease on individuals, their households, the community and national economy at large [1]. Assessing the economic burden of any illness, either a physical or mental disorder, involves estimating three types of costs which includes the direct cost, indirect cost and intangible cost [1]. Direct costs are those incurred to treat the illness and other supportive treatments including rehabilitation. Indirect costs do not involve money spent on treatment but rather consists of lost productivity which is the value of what would have been produced in the absence of illness. Intangible costs include the pains, grief, fear of the unknown associated with managing a patient which are unquantifiable
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