Estimating the economic impacts for caregivers of young people with mental health problems in a Brazilian cohort.

Objectives: To assess the indirect economic impacts on caregivers resulting from mental health problems in their children and to explore the association with characteristics of the young people and their caregivers.

Methods: Data from 1,158 caregivers of young people aged 14-23 with mental health problems in a Brazilian cohort were analysed. We assessed productivity losses, additional household tasks, out-of-pocket expenses, and own healthcare utilisation due to the young person's mental health problems over the past 6 months. Costs of productivity losses and household tasks were estimated in terms of caregivers' earnings. Logistic regression models identified factors associated with reported impacts. Generalised linear models examined clinical and caregiver characteristics associated with the economic impact on caregivers.

Results: Nearly 40% of caregivers (n=458) experienced economic impacts due to mental health issues in their children over the previous 6 months. The total economic impact among these 458 caregivers who reported incurring costs amounted to half of their earnings, and this was consistent across socioeconomic groups. Factors associated with reporting impacts differed from those affecting their costs. Externalising and comorbid diagnoses, service use, higher impairment, and female caregiver increased the likelihood of impacts, while the greatest economic impacts were associated with internalising conditions and service use.

Conclusions: While these findings need to be interpreted with caution due to inherent limitations, they underscore the substantial economic impacts borne by caregivers of young people with mental health problems, suggesting the need for targeted policy interventions to promote equitable caregiving and provide more comprehensive childcare support.