In 1991, the costs for schizophrenia, which has a lifetime prevalence of 1.5% among adult Americans, totaled 65billion.Costswerebrokendownintotheirdirectandindirectcomponents.Directcosts,whichtotaled19 billion dollars, consisted of treatment-related expenditures such as those for inpatients and outpatients, as well as nontreatment-related expenditures such as those for the criminal justice system used by individuals with schizophrenia. The direct costs were fairly similar to those of other recent estimates of the cost of schizophrenia. Indirect costs, which were 46billiondollars,includedthelostproductivityofbothwageearners(24 billion) and homemakers (4.5billion),individualswhowereininstitutions(4.5 billion) or who had committed suicide (7billion),andcaregiverswhotookcareofschizophrenicfamilymembers(7 billion). Our method for calculating the indirect costs was slightly different than methods used in prior studies, which may account for our estimates being higher. The method for determining each expenditure is provided, and the implications of these staggering costs are discussed