Economic burden of caregiving for persons with severe mental illness in sub-Saharan Africa: A systematic review

Rebecca Addo, Samuel Agyei Agyemang, Yesim Tozan, Justice Nonvignon

Research output: Contribution to journalArticle

Abstract

Background Over the past two decades, the focus of mental health care has shifted from institutionalisation to community-based programs and short hospital stays. This change means that there is an increased role for caregivers, mostly family members, in managing persons with mental illness. Although there is evidence to support the benefits of deinstitutionalisation of mental health care, there are also indications of substantial burden experienced by caregivers; the evidence of which is limited in sub-Saharan Africa. However, knowledge of the nature and extent of this burden can inform the planning of mental health services that will not only benefit patients, but also caregivers and households. Objective To systematically review the available evidence on the economic burden of severe mental illness on primary family caregivers in sub-Saharan Africa. Methods A comprehensive search was conducted in Pubmed, CINAHL, Econlit and Web of Science with no date limitations up to September 2016 using keywords such as "burden", "cost of illness" and "economic burden" to identify relevant published literature. Articles were appraised using a standardised data extraction tool covering themes such as physical, psychological and socioeconomic burden. Results Seven papers were included in the review. Caregivers were mostly family members with a mean age of 46.34, female and unemployed. Five out of seven studies (71%) estimated the full economic burden of severe mental illness on caregivers. The remainder of studies just described the caregiver burden. All seven papers reported moderate to severe caregiver burden characterised by financial constraint, productivity loss and lost employment. The caregiver’s level of income and employment status, severity of patient’s condition and duration of mental illness were reported to negatively affect the economic burden experienced by caregivers. Conclusion There is paucity of studies reporting the burden of severe mental illness on caregivers in sub-Saharan Africa. Further research is needed to present the nature and extent of this burden to inform service planning and policymaking.

Original languageEnglish (US)
Article numbere0199830
JournalPLoS One
Volume13
Issue number8
DOIs
StatePublished - Aug 1 2018

Fingerprint

behavior disorders
Africa South of the Sahara
systematic review
health care workers
Sub-Saharan Africa
Caregivers
Economics
economics
Health care
mental health
Planning
health services
Cost of Illness
Productivity
Health
cost of illness analysis
planning
Mental Health
animal technicians
Deinstitutionalization

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Economic burden of caregiving for persons with severe mental illness in sub-Saharan Africa : A systematic review. / Addo, Rebecca; Agyemang, Samuel Agyei; Tozan, Yesim; Nonvignon, Justice.

In: PLoS One, Vol. 13, No. 8, e0199830, 01.08.2018.

Research output: Contribution to journalArticle

Addo, Rebecca ; Agyemang, Samuel Agyei ; Tozan, Yesim ; Nonvignon, Justice. / Economic burden of caregiving for persons with severe mental illness in sub-Saharan Africa : A systematic review. In: PLoS One. 2018 ; Vol. 13, No. 8.
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AB - Background Over the past two decades, the focus of mental health care has shifted from institutionalisation to community-based programs and short hospital stays. This change means that there is an increased role for caregivers, mostly family members, in managing persons with mental illness. Although there is evidence to support the benefits of deinstitutionalisation of mental health care, there are also indications of substantial burden experienced by caregivers; the evidence of which is limited in sub-Saharan Africa. However, knowledge of the nature and extent of this burden can inform the planning of mental health services that will not only benefit patients, but also caregivers and households. Objective To systematically review the available evidence on the economic burden of severe mental illness on primary family caregivers in sub-Saharan Africa. Methods A comprehensive search was conducted in Pubmed, CINAHL, Econlit and Web of Science with no date limitations up to September 2016 using keywords such as "burden", "cost of illness" and "economic burden" to identify relevant published literature. Articles were appraised using a standardised data extraction tool covering themes such as physical, psychological and socioeconomic burden. Results Seven papers were included in the review. Caregivers were mostly family members with a mean age of 46.34, female and unemployed. Five out of seven studies (71%) estimated the full economic burden of severe mental illness on caregivers. The remainder of studies just described the caregiver burden. All seven papers reported moderate to severe caregiver burden characterised by financial constraint, productivity loss and lost employment. The caregiver’s level of income and employment status, severity of patient’s condition and duration of mental illness were reported to negatively affect the economic burden experienced by caregivers. Conclusion There is paucity of studies reporting the burden of severe mental illness on caregivers in sub-Saharan Africa. Further research is needed to present the nature and extent of this burden to inform service planning and policymaking.

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