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

Christopher Alan Lund, Sumaiyah Docrat, Jibril Abdulmalik, Atalay Alem, Abebaw Fekadu, Oye Gureje, Dristy Gurung, Damen Hailemariam, Yohannes Hailemichael, Charlotte Hanlon, Mark Joris Jordans, Dorothy Kizza, Sharmishtha Nanda, Saheed Olayiwola, Rahul Shidhaye, Nawaraj Upadhaya, Graham John Thornicroft, Dan Chisholm

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Abstract

Background
Little is known about the household economic costs associated with mental, neurological and substance use (MNS) disorders in low- and middle-income countries.

Aims
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.

Method
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).

Results
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.

Conclusions
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.
Original languageEnglish
Article numbere34
JournalBJPsych Open
Volume5
Issue number3
Early online date8 Apr 2019
DOIs
Publication statusPublished - 1 May 2019

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