Cost of Mental Illness and Depression in Developing Countries: A Case Study of Pakistan

Depression causes a substantial burden to persons, their beloved ones, and the nations as a whole. Major depression results in disability, high morbidity, high mortality, suicides, physical and mental impairment, and deteriorates the quality of life in a society. Depression is common in developing countries like Pakistan. This study analyzes the economic burden of depression and depressive disorders in Pakistan. The study was conducted in Pakistan’s third largest city, Faisalabad. Respondents were selected using a multistage sampling technique. As a first step, hospitals were selected from both the public and private sectors. In step two, respondents were selected and interviewed using a well-structured and pre-tested questionnaire. Review of literature reveals that the largest share of the burden of depression and depressive disorders is in the form of indirect cost. Direct healthcare cost is mostly in the form of outpatient care, doctor fee, and medicine bills, etc. This study, therefore, estimated both types of costs using cost of illness (COI) analysis. In order to find out the level of depression in patients, the center of epidemiologic studies depression (CES-D) scale was used. Then the direct and indirect cost of depression was estimated. Additionally, multiple regression analysis was used to examine the determinants of health cost, including the level of depression. The direct and indirect costs of depression were 11,108 Pakistani Rupees (PKR) and 4,869 PKR per month, respectively. Results of regression analysis revealed that besides the level of depression, monthly income, age, education, and the number of visits to a doctor’s clinic determine health cost, positively and statistically significant. Additionally, the occurrence of depression and anxiety was evident in adults more than other age groups. Females were suffering from this disorder comparatively more than male respondents. The economic burden related to depression is considerable, especially for those who belong to low-income group. Government should provide facilities for treatment for depression in public hospitals by keeping a special focus on less privileged groups of the population.