The rehabilitation of psychiatric patients.

The Costs of Psychiatric Disability It is estimated that in 1968 in the United States, psychiatric illness cost $21 billion, or 3.6 percent of the gross national product (17). This figure includes costs arising from direct treatment, medications public assistance, housing expenses, hospi~ tal building and maintenance, and research. By far the. greatest portion of the cost, however, anses from lost productivity as a consequence of illness. Of the estimated $21 billion, over half is attributed to schizophrenia, which is associated with more lasting disability than any other psychiatric illness. In 1976 the estimated cost had risen to $30 billion (46). Comparable Canadian figures are not available, but recent patterns of chronic psychiatric care in this country closely parallel changes in the United States, with the same rapid decline in hospital populations as chronic patients have been transferred to community-based programs for their continuing treatment (24). It may be assumed that proportional costs for rehabilitation in this country are comparable to those cited for the United States. The commitment to provide active re~abilitat.ion for disabled psychiatric patients, Instead of the benign neglect of bygone years, entails a heavy social cost in addition to the financial one. An editorial in the British MedicaLJournal, entitled "Burden of Schizophrenia" (11), points out that it. is the relatives, usually the parents, of discharged patients who bear the burden of their care while rehabilitation is being conducted. A poignant comment by one relative is quoted: "You can put him in a