There is a growing interest in the cost-effectiveness of psychiatry in general. How do client organisations regard this growing interest?<br/> AIM: To discuss the cost-effectiveness of psychiatry in general seen from the perspective of the patient/civilian and his or her environment.<br/> METHOD: A critical appraisal of cost-effectiveness in psychiatry on the basis of a case-study and relevant developments in society.<br/> RESULTS: The increasing interest in the cost-effectiveness of psychiatry should be seen as a positive development, but we must be aware of the complexity of the factors involved and of the complications that are linked to this increased interest. One complication is that the societal benefits of psychiatry are being reduced to mere economic efficacy and another complication is that there is less concern about the benefits to the patient in terms of reduced psychiatric suffering and speedier recovery. Yet another problem is the increasing involvement of ethical issues.<br/> CONCLUSION: The cost-efficiency of psychiatry can never be assessed in isolation, i.e. as a separate issue; it depends totally on effective cooperation with the patient, his or her immediate environment and partners and fellow-citizens. The importance of the client needs to be recognised as the binding element and all efforts should be directed towards strengthening the bond between the patient/citizen and the persons in his or her immediate environment.