Economic Burden of Caring For Children With Mental Disorders Attending Psychiatric Hospitals in Ghana

ABSTRACT 

Background Family caregivers play a very important role in the management of severe mental disorders in children which has a huge economic burden on the family and the caregivers. This study aimed to estimate the economic burden of caring for children with mental disorders attending Psychiatric hospitals in Ghana. Method The study adopted the Cost of Illness Analysis Approach in estimating economic burden. The 12- item Zarit Burden Interview and EUROHIS-QOL (WHO-8) were used to assess the intangible cost and the quality of life of the caregivers respectively. Data was collected from 210 caregivers of children with mental disorders attending psychiatric hospitals in Ghana for the last six months. The economic burden was categorized into direct costs (both direct medical costs and direct nonmedical costs), indirect cost (comprises of time of travel, productivity loss due, waiting time) and intangible costs (non-monetary costs such as pains, anxiety, stress, stigma etc.), and direct cost (cost of consultation, diagnosis, drugs, etc.). The indirect costs were estimated using the productive time lost by employed workers multiplied by the daily minimum wage of the country. Results The overall unit cost for caregiving for a child with mental disorders was GHS 826.62 (USD 169.06) per month. The average indirect cost for caregiving per child was estimated at GHS 129.17 (USD 25.83) per month, representing 15% of the total cost. Averagely, the direct non-medical cost for caring for a child per month was estimated at GHS 313.15 (USD 62.63) representing 37% of the total cost of the cost incurred by caregivers. Direct medical cost per child was estimated at GHS 402.97 (USD 80.59) per month representing 48% of the total cost of caregiving. The results vi of the Zarit Burden test revealed that 35.7% of the caregivers reported low burden while 64.3% reported high burden. A high burden was found among female caregivers than in male caregivers. The EUROHIS QOL tool revealed a low quality of life across all the domains of a mean score of 24.7. Sex, marital status, and education were found to significantly influence the quality of life of caregivers with male having a lower quality of life ( mean score of 24.1 ) as compared to female who recorded a mean score of 24.9 . Conclusion The cost incurred by caregivers of children with mental disorders in Ghana is enormous and cannot be overlooked. The gravity of the burden affects the quality of life of the caregivers. This has led to more of the caregivers reporting lower quality of life. The results of this study could be generalized for the entire population of Ghana since the three main Psychiatric Hospitals in Ghana.