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Effective Interventions In Schizophrenia: The Economic Case

A report prepared for the Schizophrenia Commission.

Schizophrenia has very significant economic consequences. Costs fall on many different parts of society, especially on individuals with schizophrenia and their families. Overall, the total societal cost in England is estimated at £11.8 billion per year and the cost to the public sector at £7.2 billion. This equates to an average annual cost to society of £60,000 and to the public sector of £36,000 per person with schizophrenia.

These costs arise in many different ways. Some direct costs of schizophrenia appear both as costs to society and to the public sector: examples are in-patient hospital costs and support from community mental health teams. Other costs, such as those associated with unpaid care by family or friends, are very real costs for society but do not have a direct impact on public spending. Lost potential output due to higher unemployment rates and premature mortality for people with schizophrenia represent huge costs for society and also translate into indirect costs for the public sector via the loss of tax revenue. We identify eight key cost drivers associated with schizophrenia: inpatient time; disrupted / loss of employment; disrupted education; homelessness; physical health problems; substance misuse; contact with the criminal justice system; and the impact on the family. In our work we found many areas where the availability and quality of economic evidence were disappointing, both in terms of accurately estimating the true costs associated with schizophrenia and in being able to draw firm conclusions. We identified a particular lack of evidence relating to costs incurred through disrupted educational opportunities, homelessness and contact with the criminal justice system.

Due to the nature of schizophrenia, many related costs are non-retrievable. Our work focused on areas of the current care and treatment system in England that could potentially be made more cost-effective.