The cost of schizophrenia

In 1988, the management of mental illness in the United States cost an estimated $129.3 billion which comprises direct costs (hospital/institution costs, health care provider fees, prescription drugs), indirect costs (reduced/lost productivity due to morbidity or mortality) and other costs including productivity of family caregivers. The largest mental health care expenditure is for schizophrenia due to the high prevalence of this illness, early age of onset, and pattern of chronicity. This paper reviews three aspects of the care of schizophrenia that have an impact on cost: 1. prevention of relapse; 2. provision of community care; and 3. use of new antipsychotic medications. Better compliance, community-based care incorporating clinical case management and improved treatments can be expected to lower costs while improving the quality of life and social functioning of patients.