The Value of Informal Caregiver Time for Psychotic Illness

Background: Psychotic illness can have a substantial economic burden not only on the patient and society in general, but also on family members providing informal care (i.e. those not subject to a market wage). While informal caregiving confers benefits for the patient and society, time spent providing informal care is diverted from other activities such as work or leisure. Relatives and caregivers experience burden both on a practical and an emotional level. Informal caregiving has often gone unrecognised in public policy discussions about the financing and costs of health care. Aim: The aim of this paper is to provide suggestions for valuing caregiver time for psychotic illness. Materials and Methods Literature on the costs of informal care and the cost of leisure time, is used to discuss possibilities for estimating the value of informal care. Results: The monetary value of informal care depends on income levels both for those who give up paid work and for those who forego leisure time. Estimates are thus context dependent and might be difficult to generalise. Discussion: Informal care is a substantial part of total patient care, especially for chronic illness. The support of family caregivers for patients with mental illnesses often has an important impact on the general well-being of the patient. Because it is typically unpaid, informal care has been seen as a low cost, even costless, substitute for formal care. Placing a value on the hours of care provided by informal caregivers for patients suffering from mental illnesses is necessary if one wants to provide an accurate picture of the costs associated with the diseases. Time spent on informal care has a value and methods of estimating costs of informal care are available. Implications for Health Care Provision and Use: Cost studies should take account of the cost of informal care, as ignoring informal care means that it is viewed as a costless substitute for formal care. While informal care is unpaid, it is not free in an economic sense since time spent providing care cannot be directed to other activities such as paid work or leisure. From a societal perspective, not accounting for informal care may lead to a poor allocation of resources and a disregard of the effect of informal care on the health and well-being of caregivers. Cost of informal care constitutes a sizeable proportion of total costs and should not be neglected.