An analysis of financial hardship faced by patients with First Episode Psychosis, and their families, in an Indian setting
Bhogal, Jasmine Singh, Swaran Preet Chadda, Rakesh K Sood, Mamta Shah, Jai Iyer, Srividya N Madan, Jason
Bhogal, Jasmine
Singh, Swaran Preet
Chadda, Rakesh K
Sood, Mamta
Shah, Jai
Iyer, Srividya N
Madan, Jason
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Affiliation
Warwick Medical School, Coventry; All India Institute of Medical Sciences; McGill University, Montreal; Coventry and Warwickshire Partnership Trust;
Other Contributors
Publication date
2024-07
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Background
The economic burden of psychotic disorders is not well documented in LMICs like India, due to several bottlenecks present in Indian healthcare system like lack of adequate resources, low budget for mental health services and inequity in accessibility of treatment. Hence, a large proportion of health expenditure is paid out of pocket by the households.
Objective
To evaluate the direct and indirect costs incurred by patients with First Episode Psychosis and their families in a North Indian setting.
Method
Direct and Indirect costs were estimated for 87 patients diagnosed at AIIMS, New Delhi with first-episode psychosis (nonaffective) in the first- and sixth month following diagnosis, and the six months before diagnosis, using a bespoke questionnaire. Indirect costs were valued using the Human Capital Approach.
Results
Mean total costs in month one were INR 7991 ($107.5). Indirect costs were 78.3% of this total. Productivity losses was a major component of the indirect cost. Transportation was a key component of direct costs. Costs fell substantially at six months (INR 2732, Indirect Costs 61%). Respondents incurred substantial costs pre-diagnosis, related to formal and informal care seeking and loss of income.
Conclusion
Families suffered substantial productivity loss. Care models and financial protection that address this could substantially reduce the financial burden of mental illness. Measures to address disruption to work and education during FEP are likely to have significant long-term benefits. Families also suffered prolonged income loss pre-diagnosis, highlighting the benefits of early and effective diagnosis.
Citation
Jasmine Bhogal, Swaran Preet Singh, Rakesh Chadda, Mamta Sood, Jai L. Shah, Srividya N. Iyer, Jason Madan, An analysis of financial hardship faced by patients with First Episode Psychosis, and their families, in an Indian setting, Asian Journal of Psychiatry, Volume 97, 2024, 104066, ISSN 1876-2018, https://doi.org/10.1016/j.ajp.2024.104066.
Type
Article