Household economic costs associated with mental, neurological and substance use disorders: a cross-sectional survey in six low- and middle-income countries

Abstract

BackgroundLittle is known about the household economic costs associated with mental, neurological and substance use (MNS) disorders in low- and middle-income countries.AimsTo 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.MethodWe 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).ResultsDespite 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.ConclusionsHouseholds living with a member who has an MNS disorder constitute an economically vulnerable group who are susceptible to chronic poverty and intergenerational poverty transmission.Declaration of interestD.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.

Keywords

• Economic costs
• mental illness
• low and middle-income countries
• household