National and State Societal Costs of Schizophrenia in the US in 2024

JAMA Psychiatry. 2026 Jan 28. doi: 10.1001/jamapsychiatry.2025.4383. Online ahead of print.

ABSTRACT

IMPORTANCE: Schizophrenia imposes a substantial burden on individuals and society. Population-specific cost estimates are essential to inform evidence-based policy, allocate resources, and support recovery-focused care that improves outcomes.

OBJECTIVE: To estimate national and state-level burden of schizophrenia to inform population-specific care and services in the US in 2024.

DESIGN, SETTING, AND PARTICIPANTS: This was an observational prevalence-based cost-of-illness model estimating total excess direct medical, direct nonmedical, and indirect costs of schizophrenia by combining inputs from a targeted literature review and an analysis of Medical Expenditure Panel Survey data, adjusted to 2024 US dollars. The setting included independent households, supportive housing, long-term care and skilled nursing facilities, unhoused settings, and prisons and jails. Disease-related costs were estimated for adults living with schizophrenia spectrum disorders.

EXPOSURES: Health care, supportive housing, homelessness, social security disability benefits, justice system, employment, productivity, quality of life, mortality, and caregiver impact across settings of care.

MAIN OUTCOMES AND MEASURES: Prevalence-based national and state cost of schizophrenia by category or sector.

RESULTS: The societal cost of schizophrenia in 2024 was estimated at $366.8 billion in the US for 3 070 739 adults (1.17%) across all settings (68.4% independent households, 18.6% supportive housing, 5.0% long-term care or skilled nursing facility, 4.7% incarcerated, 3.3% unhoused). Direct costs ($75.0 billion) were attributable to health care ($36.7 billion), supportive housing and homelessness ($35.2 billion), justice system interactions ($11.9 billion), and social security disability benefits ($5.1 billion). Indirect costs ($291.8 billion) resulted from lost wages ($55.4 billion) and reduced quality of life ($41.4 billion) and life expectancy ($47.5 billion). Indirect costs for caregivers of individuals with schizophrenia included unpaid wages for time providing care ($104.6 billion) and impact on caregiver health, productivity, and out-of-pocket costs ($60.5 billion). Per-person costs of schizophrenia were estimated at $119 436 nationally in 2024. State-level per-person costs ranged from $110 975 in Utah to $126 225 in Alaska.

CONCLUSIONS AND RELEVANCE: In 2024, the national and state-level costs of schizophrenia in the US estimated from a societal perspective suggest a substantial burden of disease on individuals, families, and society. These findings provide an important framework to guide prevention, care, and management strategies to reduce costs and improve public health outcomes.

PMID:41604174 | DOI:10.1001/jamapsychiatry.2025.4383