OBJECTIVES: Although BD is considered similar to schizophrenia due to its episodic and chronic nature and its association to functional disability and excessively high morbidity and mortality, the Brazilian Mental Health Program is a federal program only for the treatment of schizophrenia. There is no published literature on the use of healthcare resources by individuals with BD in Brazil that could be useful to debate about a public Brazilian program for BD. The aim of this study was to estimate the BD resource use in the Brazilian public health system METHODS: Large data bases can be used to estimate patient healthcare resource consumption but they are not always available. One reasonable data source is soliciting expert opinion from clinicians. Therefore, we performed a modified Delphi panel in order to delineate practice patterns and to obtain resource utilization data (hospitalization, ambulatory, emergency room services, group therapy and physician visits) for the routine treatment and monitoring, representative of community physicians BD management. Responses were obtained from eight psychiatrists experienced in treating BD from different Sao Paulo public psychiatric centers RESULTS: According to the panel manic episodes represent 20% of the bipolar episodes, make 90% of the patients seek emergency rooms leading to an average 15 days hospitalization in 75% of these patients. On the other hand, depression episodes are 80% of the bipolar episodes make 5% of the patients seek emergency rooms leading to an average 30 days hospitalization in 60% of these patients. 70% of BD patients are unable to work. Treatment non adherence rate is about 80% of which 60% are due to the lack of public health services availability CONCLUSION: The burden of bipolar disorder is substantial. Poor access to treatment and services are leading to high non adherence rates and a potential significant impact on indirect costs