Here is the abstract.
In India, expenditure incurred to access mental health services often drives families to economic crisis. Families of Persons with mental illness (PMI) incur ‘out-of-pocket’ (OOP) expenditure for medicines, psychiatrist fee and travel in addition to losing wages on the day of visiting psychiatrist.
Aim: To describe impact of Community Based Rehabilitation (CBR) on OOP expenditure incurred by families of persons with severe mental illness (PSMI).
Methods: The sample comprised 95 PSMI who switched from treatment from other mental health facilities to CBR at Jagaluru, India.
Results: The PSMI were predominantly male (52%) with mean age 41 years and diagnosed with psychosis (75%). Most of them (84%) were earlier taking treatment from private sector and spent on an average Rs. 15,074 (US $ 215) per PSMI per annum in availing treatment. After availing CBR, the annual expenditure reduced to Rs 492 (US $ 7) on an average per PSMI. OOP expenditure on medicines (largest head of expenditure) and psychiatrist consultation fee dropped to zero.
Discussion: After excluding costs incurred to run the CBR, the net savings for the system for 95 PSMI included in study alone was Rs 3,83,755 (US $ 5,482) per annum. The amount would be much higher on including savings for PSMI initiated on treatment for the first time and PMI on regular follow-up in CBR.
Conclusions: Provision of CBR in partnership with public health system and NGO’s leads to dramatic fall in OOP health expenditure of families of PSMI. It is also cost-effective to the system.
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