The economic cost of schizophrenia reached nearly $367 billion for roughly 3.1 million US adults in 2024, driven largely by unpaid caregiving, premature mortality, unemployment, and other indirect costs, new research showed.

Almost 80% of the national estimate was driven by indirect costs, with healthcare accounting for just 10% of total costs and less than 50% of direct costs

Additionally, there was a national per-person cost from schizophrenia of nearly $120,000. Per-person costs at the state level ranged from $111,000 to $126,000.

State estimates, while also high, varied because of numerous factors, such as population size, employment and homelessness rates, wages, and cost of living.

Overall, the findings “suggest a substantial burden of disease on individuals, families, and society,” lead author Holly B. Krasa, MS, Schizophrenia and Psychosis Action Alliance, Alexandria, Virginia, and colleagues wrote. 

“These national- and state-level estimates provide a clearer foundation for targeting care, guiding investment, and expanding early intervention to reduce the long-term impact of schizophrenia,” they added. 

The findings were published online on January 28 in JAMA Psychiatry. 

‘Multisector Burden’

A cost-of-illness model used input from Medical Expenditure Panel Survey data, adjusted for 2024 amounts, and a targeted literature review.

The study’s main outcome was “prevalence-based national and state cost of schizophrenia by category or sector,” the researchers wrote.

Results showed the estimated national societal cost of schizophrenia was $366.8 billion. Among the more than 3 million adults with schizophrenia spectrum disorders included in the analysis, 68% were part of independent households, 19% were in supportive housing, 5% were in long-term or skilled nursing care, 5% were incarcerated, and 3% were unhoused.

Of the total national estimate, 20% was from direct costs. This included healthcare ($37 billion), homelessness and supportive housing ($35 billion), justice system factors ($12 billion), and benefits from social security disability ($5 billion).

Indirect costs included unpaid wages and out-of-pocket expenses for caregivers ($149 billion after cost offsets), patient unemployment and reduced wages ($55 billion), premature mortality ($47 billion), and quality-of-life issues ($41 billion).

On the state level, total schizophrenia costs varied, with California’s costs at $45.6 billion and Wyoming’s at $600 million. Alaska had the highest per-person cost at $126,222, while Utah had the lowest at $110,975.

Cost-of-living differences, size of unhoused populations, and mortality rates were among the factors that affected local variations in costs.

“These findings suggest a substantial, multisector schizophrenia-related economic burden with state-level variation, highlighting the need for coordinated care and cross-sector responses,” the investigators wrote.

However, funding remains low for both treatment and research, they noted. 

“A sustained research agenda is essential to drive innovation, improve care delivery, and reduce the long-term costs,” they added.

The study was funded by the Schizophrenia and Psychosis Action Alliance, which also employed one of the researchers. Blue Persimmon Group, which employs two investigators, and Precision AQ, which employs five of the other investigators, are both life sciences consulting firms. Some of the researchers also reported having equity in at least one of the firms.