Household economic costs associated with mental, neurological and substance use disorders: a cross-sectional survey in six low- and middle-income countries.
Journal: BJPsych open
Volume: 5
Issue: 3
Year of Publication:
Affiliated Institutions:
Professor of Public Mental Health, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa; and Professor of Global Mental Health and Development, Health Services and Population Research Department, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Health Services and Population Research Department, Centre for Global Mental Health, King's College London, UK.
Research Officer, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
Senior Lecturer, Department of Psychiatry, University of Ibadan, Nigeria.
Professor of Psychiatry, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa University, Ethiopia.
Associate Professor, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa University, Ethiopia; Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
Professor of Psychiatry, Department of Psychiatry, University of Ibadan, Nigeria; and Professor Extraordinary, Department of Psychiatry, Stellenbosch University, South Africa.
Research Coordinator, Transcultural Psychosocial Organization (TPO) Nepal, Nepal.
Professor of Public Health, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa University, Ethiopia.
Research Officer, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa University, Ethiopia.
Associate Professor, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa University, Ethiopia; Reader in Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, King's College London, UK.
Reader, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Senior Advisor, TPO Nepal, Nepal.
Research Officer, Butabika National Referral and Teaching Mental Hospital, Uganda.
Research Officer, Public Health Foundation of India, India.
Lecturer, Department of Economics, Federal University of Technology, Nigeria.
Public Health Foundation of India, India.
Research Officer, TPO Nepal, Nepal; Research and Development Department, HealthWorks, the Netherlands.
Professor of Community Psychiatry, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, King's College London, UK.
Health Systems Adviser, Department of Mental Health and Substance Abuse, World Health Organization, Switzerland.
Abstract summary
Little is known about the household economic costs associated with mental, neurological and substance use (MNS) disorders in low- and middle-income countries.To assess the association between MNS disorders and household education, consumption, production, assets and financial coping strategies in Ethiopia, India, Nepal, Nigeria, South Africa and Uganda.We conducted an exploratory cross-sectional household survey in one district in each country, comparing the economic circumstances of households with an MNS disorder (alcohol-use disorder, depression, epilepsy or psychosis) (n = 2339) and control households (n = 1982).Despite some heterogeneity between MNS disorder groups and countries, households with a member with an MNS disorder had generally lower levels of adult education; lower housing standards, total household income, effective income and non-health consumption; less asset-based wealth; higher healthcare expenditure; and greater use of deleterious financial coping strategies.Households living with a member who has an MNS disorder constitute an economically vulnerable group who are susceptible to chronic poverty and intergenerational poverty transmission.D.C. is a staff member of the World Health Organization. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the decisions, policy or views of the World Health Organization.
Authors & Co-authors:
Lund Crick C
Docrat Sumaiyah S
Abdulmalik Jibril J
Alem Atalay A
Fekadu Abebaw A
Gureje Oye O
Gurung Dristy D
Hailemariam Damen D
Hailemichael Yohannes Y
Hanlon Charlotte C
Jordans Mark J D MJD
Kizza Dorothy D
Nanda Sharmishtha S
Olayiwola Saheed S
Shidhaye Rahul R
Upadhaya Nawaraj N
Thornicroft Graham G
Chisholm Dan D
Study Outcome
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