TY - JOUR
T1 - Quantifying the size of the informal care sector for Australian adults with mental illness
T2 - caring hours and replacement cost
AU - Diminic, Sandra
AU - Lee, Yong Yi
AU - Hielscher, Emily
AU - Harris, Meredith G.
AU - Kealton, Jan
AU - Whiteford, Harvey A.
N1 - Funding Information:
Informal care is a largely invisible but nonetheless critical part of the health system. This care may supplement or replace formal community supports for people with mental illness and psychosocial disability []. In Australia, the latter are largely funded by national and state governments directly or through grants or payments to non-government organisations (NGOs) [, ]. Carers frequently make significant personal and professional sacrifices to ensure their loved ones are adequately supported [–], including filling gaps in coordination and support resulting from a less than perfect health and social care system []. Without this unpaid care it is likely that people with mental illness would require equivalent support from formal services or would receive less overall support and have poorer outcomes [, ]. Since informal care is not organised or administered through governments or other agencies, it is an often overlooked part of the health system []. However, assuming that this care is unimportant or a free alternative to providing formal services disregards the significant interdependencies between supply and demand for formal and informal supports []. Informal care provides important value not only to care recipients but to governments and the health system [, , ].
Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2021/3
Y1 - 2021/3
N2 - Purpose: To quantify and value the total informal support provided by family and friends to Australian adults with mental illness in 2018. Methods: The number of mental health carers was drawn from the 2015 Survey of Disability, Ageing and Carers (SDAC), adjusted to the 2018 population. Annual caring hours by type of assistance were estimated using the SDAC, 2007 National Survey of Mental Health and Wellbeing and an online carer survey. Caring hours for each task were assigned an hourly replacement cost from the National Disability Insurance Scheme. Informal caring was valued as the sum of these costs minus expenditure on carer income support payments, estimating how much it would hypothetically cost governments to replace this care with formal support services. Results: An estimated 354,000 (95% uncertainty interval (UI): 327,000–383,000) Australian mental health carers provided 186 million (95% UI: 159–215) hours of support in 2018. The estimated replacement cost was AU$8.4 billion (95% UI: 7.0–10.0), excluding AU$1.3 billion in income support. Univariate sensitivity analyses demonstrated that results were robust to variation in model inputs, with total caring hours the most influential parameter. Using an alternative estimate of mean caring hours, the replacement cost could be as high as AU$13.2 billion (95% UI: 11.2–15.4). Conclusion: Informal carers provide substantial support to people with mental illness, highlighting their important contribution to the mental health system and reinforcing the need for carer support services. Future valuation studies would benefit from refinement of available data collections, particularly on hours and types of care provided.
AB - Purpose: To quantify and value the total informal support provided by family and friends to Australian adults with mental illness in 2018. Methods: The number of mental health carers was drawn from the 2015 Survey of Disability, Ageing and Carers (SDAC), adjusted to the 2018 population. Annual caring hours by type of assistance were estimated using the SDAC, 2007 National Survey of Mental Health and Wellbeing and an online carer survey. Caring hours for each task were assigned an hourly replacement cost from the National Disability Insurance Scheme. Informal caring was valued as the sum of these costs minus expenditure on carer income support payments, estimating how much it would hypothetically cost governments to replace this care with formal support services. Results: An estimated 354,000 (95% uncertainty interval (UI): 327,000–383,000) Australian mental health carers provided 186 million (95% UI: 159–215) hours of support in 2018. The estimated replacement cost was AU$8.4 billion (95% UI: 7.0–10.0), excluding AU$1.3 billion in income support. Univariate sensitivity analyses demonstrated that results were robust to variation in model inputs, with total caring hours the most influential parameter. Using an alternative estimate of mean caring hours, the replacement cost could be as high as AU$13.2 billion (95% UI: 11.2–15.4). Conclusion: Informal carers provide substantial support to people with mental illness, highlighting their important contribution to the mental health system and reinforcing the need for carer support services. Future valuation studies would benefit from refinement of available data collections, particularly on hours and types of care provided.
KW - Caregiver
KW - Economic value
KW - Mental health
KW - Proxy good
KW - Replacement cost
UR - https://www.scopus.com/pages/publications/85083849176
U2 - 10.1007/s00127-020-01868-y
DO - 10.1007/s00127-020-01868-y
M3 - Article
C2 - 32296867
AN - SCOPUS:85083849176
SN - 0933-7954
VL - 56
SP - 387
EP - 400
JO - Social Psychiatry and Psychiatric Epidemiology
JF - Social Psychiatry and Psychiatric Epidemiology
IS - 3
ER -
SDG 3 Good Health and Well-being