The economic impact of subthreshold and clinical childhood mental disorders

<i>Background</i>: Mental disorders are common health problems associated with serious impairment and economic impact. <i>Aims</i>: To estimate the costs of clinical and subthreshold mental disorders in a sample of Brazilian children. <i>Method</i>: The High Risk Cohort Study is a community study conducted in two major Brazilian cities. Subjects were 6-14 years old children being registered at school. From an initial pool of 9937 children, two subgroups were further investigated using a random-selection (<i>n</i> = 958) and high-risk group selection procedure (<i>n</i> = 1554), resulting in a sample of 2512 subjects. Mental disorder assessment was made using the Development and Well-Being Assessment. Costs for each child were estimated from the following components: mental health and social services use, school problems and parental loss of productivity. <i>Results:</i> Child subthreshold and clinical mental disorders showed lifetime mean total cost of $1750.9 and $3141.2, respectively. National lifetime cost estimate was $9.9 billion for subthreshold mental disorders and $11.6 billion for clinical mental disorders (values in US$ purchasing power parity). <i>Conclusions</i>: This study provides evidence that child mental disorders have a great economic impact on society. There is an urgent need to plan an effective system of care with cost-effective programs of treatment and prevention to reduce economic burden.