ABSTRACT
Background
Youth who are caregivers (called young caregivers [YCs]) take more responsibility than is typically expected of their peers. We investigated the association between individuals' roles as YCs and depressive symptoms and school engagement, and whether social support mediated the YCs–depression relationship.
Methods
We utilized data from a school questionnaire survey conducted in 2021 among 15,145 adolescents aged 10–15 years from 73 public schools in a municipality in Tokyo, Japan (response rate: 94%). Modified Poisson regression with robust variance was performed to investigate the association between YCs and depression or poor school engagement, adjusting for confounders. We also assessed the mediating effect of social support between being a YC and depressive symptoms.
Results
YCs were significantly associated with an increased risk of depression (risk ratio 2.31; 95% confidence interval: 1.75, 3.07). The association between being a YC and depression was partly mediated by social support and interactions. Furthermore, being a YC was associated with an increased risk of poor school engagement.
Implications for School Health Policy, Practice, and Equity
These findings highlight the need for school health systems to identify and support often‐invisible YCs.
Conclusions
Being a YC was associated with depression. Social support may mediate this association.
Keywords: adolescents, depression, poor school engagement, young caregivers
1. Introduction
Youth who are caregivers (also called young caregivers [YCs]) are children or adolescents who provide care or support to family members with illness, disability, mental health problems, or other care needs [1]. YCs provide physical and emotional care to family members with disabilities, perform household chores, and take care of younger siblings [1, 2]. YCs assume more responsibility than is typically expected of their peers [3]. Studies have shown that YCs are less likely to be employed, have a lower socioeconomic status, and experience poorer mental health when they become adults than non‐YCs [4]. Several epidemiological studies have also suggested that YCs have an increased risk of impaired mental health compared to non‐YCs [5, 6, 7, 8, 9]. Results from a school survey in Austria suggest that YCs are more likely to be tired, be worried, and feel sad than non‐YCs [7]. A longitudinal study in the UK showed that being a YC increases the risk of psychological symptoms at the age of 18–19 [10]. YCs are more likely to spend less time with their peers because they care for their families [2, 11]. Good relationships with peers give YCs a sense of belonging, acceptance, and enjoyment at school [12, 13, 14]. A lack of time with friends increases the risk of depression [15].
Furthermore, YCs may also have poor school engagement because of their family‐caregiving responsibilities [2, 16, 17]. The National statistics from England show that YCs have a higher prevalence of school absenteeism than non‐YCs [18]. Qualitative research further suggests that caregiving demands can lead to fluctuating daily routines, resulting in lateness, missed classes, or unplanned absences because of unexpected family needs [2, 16]. In addition to engagement problems, YCs often face challenges in completing schoolwork and engaging in home‐based learning. A study found that approximately 70% of YCs expressed concern about their schoolwork [19]. These difficulties may arise from a lack of time or a distracting environment for homework [2]. In later life, poor school engagement is associated with unemployment and low socioeconomic status [17]. Furthermore, the coronavirus pandemic has brought challenges to YCs, potentially increasing the risk of depression and poor school performance because of increased care burdens and reduced opportunities for respite care [20].
However, these earlier studies on poor school engagement among YCs are limited to qualitative studies [2, 16, 17]. Furthermore, data regarding the association between being a YC and depression during the pandemic are not available. Although several quantitative studies have indicated that YCs have an increased risk of depression [5, 6, 8, 21], the underlying mechanisms remain unclear. Informal care stress theory proposes that social support mediates the link between providing informal care and depression [22]. Supporting this framework, previous studies of the general adolescent population have shown that lower perceived social support is associated with higher levels of depressive symptoms [23, 24, 25]. In addition, reduced opportunities for social interaction, such as limited peer contact and school disengagement, have been linked to poor mental health in adolescents [21, 26]. YCs may be more prone to depression due to limited social support and social interaction because of poor school engagement and caregiving responsibilities [2, 18, 21]. Thus, lack of social support may mediate the association between being a YC and depression.
Although previous studies have examined the association between YCs and depression, no quantitative studies have empirically examined the mediating roles of social support and social interaction in this relationship. Furthermore, evidence on school engagement among YCs remains limited.
This study aimed to investigate the associations between individuals' roles as YCs and depression. We also investigated whether social support and social interaction mediated the association between individuals' roles as YCs and depression. Furthermore, we investigated the associations between being a YC and school engagement as a secondary outcome.
2. Materials and Methods
2.1. Data Sources and Participants
This study utilized data from Itabashi children's Survey, a cross‐sectional school survey conducted by the local board of education in a municipality of Tokyo in December 2021. This survey aimed to investigate the mental health problems of adolescents and develop mental health care systems at school. The local board of education in one municipality of Tokyo administered questionnaires to all adolescents in grades 5–9 (ages 10–16) at all 72 public schools within the municipality, including 51 elementary schools and 21 junior high schools. Anonymous paper‐based questionnaires were distributed to adolescents at each school. The mean household income in the municipality was slightly lower than the nationwide average income of Japan [27].
We excluded from the analysis adolescents who attended classes on special educational needs and adolescents who did not answer questions regarding YCs, depressive symptoms, social support, and social interaction. In total, 15,145 adolescents were included in this study. The response rate was 94.3%.
The ethics committee at the National Center for Child Health and Development exempted this study from study protocol review because of the secondary analysis of anonymous survey data (ethical file number 0016, January 7, 2022).
2.2. Young Caregivers (YCs)
The roles of adolescents as YCs were assessed using a self‐report questionnaire adapted from the Japanese Carers Association [28, 29]. Adolescents chose the following six items: (1) assisting a family member with a disability or illness by doing household chores, such as shopping, cooking cleaning, and laundry, instead of family members with disability and disease (Household chores), (2) caring for younger siblings on behalf of the family (Care for younger siblings), (3) caring for a family member with a disability or illness (Care for disabled), (4) working to support the household and helping a family member with a disability or illness (Work for family), (5) working with families with alcoholism, substance abuse, or gambling problems (Care for addiction), and (6) working as an interpreter for families where Japanese is not the first language or for families with disabilities, instead of family members with disabilities and diseases (Oral translation). YCs were defined as adolescents who cared for families in any of the above six items, and non‐YCs were defined as those who did not.
2.3. Outcomes
We assessed depression using the Patient Health Questionnaire for Adolescents (PHQ‐A) [30, 31]. The PHQ‐A is a modified version of the Patient Health Questionnaire designed for adults and adapted to provide developmentally appropriate screening for depression in adolescents. The PHQ‐A is based on the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [32] and has been validated in adolescents [27]. The PHQ‐A has been translated into Japanese [31]. It consists of nine questions on how frequently adolescents have experienced depressive symptoms in the previous 7 days. The response options and associated scores ranged from 0 (not at all) to 3 (nearly every day). Higher scores indicated greater levels of depressive symptoms. Severity of depression was originally categorized into none (0–4), mild [5, 6, 7, 8, 9], moderate [10, 11, 12, 13, 14], moderately severe [15, 16, 17, 18, 19], and severe [20, 21, 22, 23, 24, 25, 26, 27, 31]. Because a validated cutoff for severe depression using the PHQ‐A has not been established among Japanese adolescents, we used a score of ≥ 15 to indicate severe depressive symptoms based on previous studies using the PHQ scale in adolescent populations [33].
Poor school engagement in the previous month was assessed as follows: (1) adolescents' absence from school, (2) being late for school or leaving it early, and (3) failing to submit homework and assignments. The following choices were included: “almost none,” “occasionally,” “often,” “I do not want to answer,” or “I do not know.” These items were developed specifically for this school survey. The answer options for each question were categorized into two groups: “occasionally or often” and “almost none.” The response option “I do not want to answer, or I do not know” was excluded from the analysis because its low frequency did not allow us to retain it as a separate category.
2.4. Mediators
We assessed social support using the following question: Do you have someone to whom you can talk about your problems or concerns? Children chose one of the following options: “none,” “one or two persons,” “three and more,” or “I do not want to talk about it.” Social support was divided into two categories: “none or I do not want to talk about it” (lack of social support) and “one or more persons.” This classification reflects the perspective that reluctance to talk about personal problems may indicate limited access to, or trust in, available support and thus constitute a functional lack of social support [34]. As a sensitivity analysis, we additionally classified social support into three categories: “none,” “I do not want to talk about it,” and “one or more persons,” to examine the robustness of the findings (Figure 1).
FIGURE 1.
Mediation analysis model of the relationship between caregiving and depression, using social support and interaction as mediators.
We assessed lack of social interaction with friends with the following item: I did not have much time to play or talk with my friends [35]. Children chose one of the following options: “almost never,” “sometimes,” “often,” “I do not know,” or “I do not respond.” Social interaction was categorized into “almost never” (lack of social interaction) and “sometimes” or “often.”
2.5. Covariates
Children's grade, gender, and subjective socioeconomic status of children were assessed using self‐reported questionnaires. Children chose one of the following choices for gender: boy, girl, or do not want to answer. Subjective socioeconomic status was assessed with the following question: “Please choose the option that best describes how you feel about your home life.” Children chose one of the following options: “fairly poor,” “slightly poor,” “fair,” “slightly rich,” and “fairly wealthy.”
2.6. Statistical Analyses
We report demographic characteristics according to YC or non‐YC. Chi‐square tests were conducted to compare the two groups.
Multivariate modified Poisson regression with robust variance was performed to investigate the association between an individual's role as a YC and depressive symptoms, adjusted for grade, sex, and socioeconomic status. We present risk ratios (RR) and 95% confidence intervals (95% CIs). Additionally, mediation analysis was performed to assess the mediating effect of social support and social interaction in the relationship between YCs and depression. We calculated the total effect, natural indirect effects, and natural direct effects of being a YC and depression using a counterfactual‐based mediation framework via g‐computation. A parallel two‐mediator model was used to examine the mediating effects.
Furthermore, we used multivariate modified Poisson regression with robust variance to examine the association between being a YC and poor school engagement (being absent from school, being late for school, and failing to submit homework). Children who selected “I do not know” or “I do not respond” were treated as missing values and excluded from the analysis.
We also investigated six types of care (household chores, care for younger siblings, care for disabled individuals, work for family, care for addiction, and oral translation) in relation to depression and poor school engagement.
A two‐sided p‐value of < 0.05 was considered statistically significant. All statistical analyses were conducted using STATA version 16.1 (STATA Corp, Texas, USA).
3. Results
A total of 15,145 adolescents were included in the analysis. Among all adolescents, 4% were YCs. The most prevalent type of care was care for younger siblings (5.7%), followed by household chores (2.2%), and translation (1.1%). Depression rates were 4.4% and 1.6% in YCs and non‐YCs, respectively (Table S1).
Table 1 shows the characteristics of the study participants, who were grouped into YCs and non‐YCs. YCs were more likely to be girls and have low socioeconomic status, lack social support, and have less frequent social interaction with friends. Table S2 shows the demographic characteristics and social aspects of YCs according to types of care provided. Adolescents who provide care for family members with addiction problems were more likely to lack social support than those who did not (38.0% vs. 62.0%, p < 0.001).
TABLE 1.
Demographic characteristics and social aspects of young caregivers and their non‐caregivers.
| Young caregiver | Non‐young caregiver | |||||
|---|---|---|---|---|---|---|
| n | (%) | n | (%) | p | ||
| Grade | 5 | 327 | (22.9) | 3323 | (24.2) | 0.001 |
| 6 | 293 | (20.5) | 3264 | (23.8) | ||
| 7 | 282 | (19.7) | 2392 | (17.4) | ||
| 8 | 298 | (20.9) | 2400 | (17.5) | ||
| 9 | 228 | (16.0) | 2338 | (17.0) | ||
| Gender | Boys | 631 | (44.2) | 6783 | (49.4) | < 0.001 |
| Girls | 708 | (49.6) | 6230 | (45.4) | ||
| Unknown or don't want answer | 89 | (6.2) | 704 | (5.1) | ||
| Subjective socioeconomic status | Pretty poor | 14 | (1.0) | 66 | (0.5) | < 0.001 |
| Slightly poor | 118 | (8.3) | 562 | (4.1) | ||
| Average | 843 | (59.0) | 9075 | (66.2) | ||
| Slightly rich | 273 | (19.1) | 2636 | (19.2) | ||
| Pretty rich | 137 | (9.6) | 1048 | (7.6) | ||
| Missing data | 43 | (3.0) | 330 | (2.4) | ||
| Lack of social support | Yes | 329 | (23.0) | 2605 | (19.0) | < 0.001 |
| No | 1099 | (77.0) | 11,112 | (81.0) | ||
| Lack of social interaction with friends | Yes | 262 | (18.3) | 2026 | (14.8) | < 0.001 |
| No | 1166 | (81.7) | 11,691 | (85.2) | ||
Note: Lack of social support was assessed based on the number of persons who sought advice. Lack of social interaction with friends was assessed based on a lack of social interaction in terms of playing or talking with my friends.
Table 2 shows the results of modified Poisson regression to investigate associations of being YC with depression. Being a YC was associated with an increased risk of depression (RR, 2.31, 95% CI, 1.75, 3.07, p < 0.001). In analyses of each type of care and depression, all types of care roles were associated with an increased risk of depression.
TABLE 2.
Association between young caregivers and depression using modified Poisson regression analyses.
| Depression | |||
|---|---|---|---|
| RR | 95% CI | p | |
| Young caregiver a | 2.31 | (1.75, 3.07) | < 0.001 |
| Types of care b | |||
| Household chores | 2.43 | (1.50, 3.95) | < 0.001 |
| Care for younger siblings | 1.67 | (1.14, 2.45) | 0.004 |
| Care for disabled | 3.49 | (1.85, 6.57) | < 0.001 |
| Work for family | 3.19 | (1.02, 10.0) | 0.035 |
| Care for addiction | 7.88 | (4.85, 12.8) | < 0.001 |
| Oral translation | 1.52 | (0.71, 3.24) | 0.254 |
Abbreviations: CI, confidence interval; RR, risk ratio.
The outcome variable in this analysis was depression; children without depression served as the reference group. The reference group for young caregivers consisted of children who did not provide care.
Results are presented separately for each type of care; in each analysis, children who did not engage in that specific type of care served as the reference group. Higher risk ratios indicate a higher risk of depression.
Table 3 shows the results of the mediation analysis with YCs as the independent variable, social support as the mediator, and depressive symptoms as the dependent variable. The total, direct, and indirect effects of social support on depression were 2.27 (95% CI 1.66–2.95, p < 0.001), 2.09 (95% CI 1.54–2.72, p < 0.001), and 1.03 (95% CI 1.00–1.07, p < 0.001), respectively. Similarly, the indirect effect of lack of social interaction with friends on depression was 1.05 (95% CI 1.01–1.10, p < 0.001). The combined effect of lack of social support and social interaction was 1.08 (95% CI 1.02–1.15, p < 0.001). Overall, 10.3% (95% CI: 1.60%–18.9%, p = 0.024) of the association with depression was explained by the proportion mediated through lack of social support and lack of social interaction with friends. Sensitivity analyses using the three response categories for social support produced similar results (Table 3).
TABLE 3.
Mediation analysis of social support and opportunities in the association between being a young caregiver and depression.
| Model pathways | Estimate | (95% CI) | p |
|---|---|---|---|
| Total effects a | 2.27 | (1.66, 2.95) | < 0.001 |
| Direct effects b | 2.09 | (1.54, 2.72) | < 0.001 |
| Indirect effects of lack of social support c | 1.03 | (1.00, 1.07) | < 0.001 |
| Indirect effects of lack of social interaction c | 1.05 | (1.01, 1.10) | < 0.001 |
| Total indirect effects d | 1.08 | (1.02, 1.15) | < 0.001 |
| Total mediating (%) e | 10.3 | (1.60, 18.9) | 0.024 |
| Mediating through lack of social support (%) | 6.45 | (0.93, 13.0) | 0.052 |
| Mediating through lack of social contact (%) | 3.80 | (−0.59, 9.21) | 0.125 |
Note: In the mediation analysis, lack of social support and reduced social interaction with friends were treated as mediators in the association between young caring and depressive symptoms. Social support was divided into two categories: “none or I do not want to talk about it” (lack of social support) and “one or more persons.
Abbreviation: CI, confidence interval.
Total excessive relative risk.
Proportional controlled direct effect.
Excess relative risk results from the pure indirect effect.
Total indirect effect of lack of social support and social interaction with friends.
Overall proportion mediated through the combined effects of lack of social support and social interaction.
Table 4 shows the results of modified Poisson regression to investigate the associations between being a YC and poor school engagement. Compared with the non‐YC group, the YC group was associated with absence from school (RR, 1.40, 95% CI, 1.26, 1.56, p < 0.001), being late for school (RR, 1.42, 95% CI, 1.28, 1.57, p < 0.001), and failing to submit homework (RR, 1.28, 95% CI, 1.19, 1.38, p < 0.001).
TABLE 4.
Association between being a young caregiver and poor school engagement using modified Poisson regression.
| Absence from school a | Being late for school b | Failing to submit homework c | |||||||
|---|---|---|---|---|---|---|---|---|---|
| RR | (95% CI) | p | RR | (95% CI) | p | RR | (95% CI) | p | |
| Young caregiver d | 1.40 | (1.26, 1.56) | < 0.001 | 1.42 | (1.28, 1.57) | < 0.001 | 1.28 | (1.19, 1.38) | < 0.001 |
| Types of care e | |||||||||
| Household chores | 1.50 | (1.23, 1.83) | < 0.001 | 1.62 | (1.35, 1.94) | < 0.001 | 1.32 | (1.14, 1.53) | 0.001 |
| Care for younger siblings | 1.32 | (1.15, 1.52) | < 0.001 | 1.26 | (1.11, 1.44) | < 0.001 | 1.19 | (1.08, 1.32) | < 0.001 |
| Care for disabled | 1.54 | (1.14, 2.08) | 0.004 | 1.07 | (0.76, 1.50) | 0.711 | 1.31 | (1.05, 1.65) | 0.019 |
| Work for family | 1.33 | (0.74, 2.41) | 0.341 | 1.35 | (0.76, 2.38) | 0.305 | 1.27 | (0.83, 1.95) | 0.274 |
| Care for addiction | 1.73 | (1.23, 2.45) | 0.002 | 1.55 | (1.10, 2.18) | 0.013 | 1.33 | (1.01, 1.75) | 0.043 |
| Oral translation | 1.33 | (0.99, 1.78) | 0.058 | 1.61 | (1.26, 2.08) | < 0.001 | 1.33 | (1.09, 1.63) | 0.006 |
Abbreviations: CI, confidence interval; RR, risk ratio.
For absence from school, the reference group was “attended school.”
For being late for school, the reference group was “no lateness.”
For failing to submit homework, the reference group was “submitted homework.”
The reference group for young caregivers consisted of children who did not provide any care.
The results are presented separately for each type of care, and in each analysis, children who did not engage in that specific type of care served as the reference group. Higher risk ratios indicate a higher risk of poor school engagement.
4. Discussion
This study found an association between adolescents' roles as caregivers and an increased risk of depression, regardless of the type of care. A lack of social support mediated the association between being a YC and depression. YCs were also associated with an increased risk of absence from school, being late for school, and failing to submit homework.
Studies in Western countries have shown that being a YC is associated with an increased risk of depression [5, 6, 36, 37]. A US study found that young adult caregivers with past and present responsibilities reported significantly more symptoms of depression than non‐caregivers [36]. Similarly, a Norwegian study found that, compared with non‐caregivers, YCs were associated with an increased risk of depression [37]. A Canadian study of children aged 8–18 years old has shown that being a YC was associated with an increased risk of depression [6]. Our study provides evidence that YCs in Asia also have an increased risk of depression.
There are several possible explanations for these results. First, informal caregiving often leads to physical and emotional exhaustion [22, 38]. Informal carers handle tasks ranging from dressing and assisting individuals with mobility challenges to providing hygiene and administering medication [2, 39]. Studies indicate that YCs undertake both typical and more age‐atypical caregiving tasks, including personal care tasks [2, 39]. For example, YCs for individuals with diabetes may require assistance early in the morning to help individuals maintain appropriate blood‐sugar levels [2]. YCs sometimes have to prepare for unforeseen events. Caring for alcoholic parents is a task that can be highly stressful [40].
Informal care stress theory proposes that social support mediates the link between providing informal care and depression [22]. Our findings support this theory, showing that social support mediates the relationship between YCs and depression.
The social role conflict model may also explain why YCs are associated with an increased risk of depression [41]. YCs face challenges in balancing the dual social roles of students and caregivers with conflicting demands or expectations, including their caregiving responsibilities and educational commitments [2, 3, 19]. Adolescence is a critical period for developing peer relationships and gaining independence from family [42]. School is a primary environment for YCs to foster peer relationships, besides their academic achievement [17]. However, YCs tend to be concerned about caring for their families [37]. A qualitative study reported that YCs believe that if they do not care for their families, no one else will [2]. This belief leads to anxiety about being unable to care for family members while attending school [2]. Consequently, YCs find themselves in a state of conflict as they struggle to fulfill their roles as caregivers and students simultaneously.
Our findings revealed that YCs were associated with greater difficulties with school engagement and homework than non‐YCs. An Australian study showed that YCs aged 14–15 years had lower levels of reading comprehension and arithmetic than non‐YCs of the same age group [43]. Consistent engagement at school is a major determinant of academic success, which, in turn, impacts later social determinants of health [44, 45].
We found that various caring activities were associated with an increased risk of depression. As shown in Table 2, YCs who cared for family members with addiction problems, such as alcoholism, illicit drug use, and gambling, were at a very high risk of depression. The high risk of depression in YCs who have addicted parents may be because the stigma associated with addiction can lead to individuals' isolation and inability to discuss their situation openly [2, 3, 46]. Our findings support this explanation. In the present study, YCs who cared for family members with addiction problems were more likely to lack social support than those whose families did not have addiction problems. Earlier studies have indicated that a reluctance to discuss parents' alcohol dependence may stem from negative social stereotypes regarding people with alcohol dependence [47, 48, 49, 50]. A UK study revealed that approximately half of individuals believed that personal shortcomings cause alcohol addiction [51]. Similarly, a study in the US suggested that alcohol addiction stems from poor character or upbringing [52]. Thus, the stigma surrounding parental addiction problems may hinder children from seeking support and coping effectively with their environment.
4.1. Implications for School Health Policy, Practice, and Equity
Our findings suggest that, regardless of sociocultural differences between Japan and Western countries, YCs should be provided with supportive environments in schools and communities to ensure they have opportunities to develop and maintain meaningful relationships. Despite their burdensome roles, YCs often remain invisible to society [53, 54, 55]. Teachers serve as the first point of contact for children. However, European studies show that they often lack sufficient time, training, and resources to support YCs [56, 57, 58]. A multidisciplinary team comprising nurses, counselors, social workers, and teachers can help identify YCs and foster an environment of social support that provides children with trusted adults they can consult when facing difficulties [57]. Collaboration with welfare and community services outside schools is essential [58]. Governments also play a key role in supporting such systems [59]. Countries such as the UK and Australia have legislation that requires local authorities to evaluate the needs of YCs and support their participation in education and social activities [60]. Few Asian countries, by contrast, have established legal frameworks for support of YCs. In Japan, support for YCs has been added to the Act on Promotion of Child and Youth Development Support in 2024 [61]. The cultural values of many Asian societies—such as the emphasis on family obligation, social harmony, and filial piety—can shape children's sense of responsibility [62, 63, 64, 65]. As a result, young people who provide care in their families might not identify themselves as YCs, and professionals might also overlook such roles. Further research is needed to identify the barriers that prevent schools from supporting YC, particularly in Asian societies.
4.2. Limitations
The main strength of this study is its large sample size, which enabled us to investigate the association between the types of care provided by children and their outcomes. Nevertheless, some limitations were acknowledged. First, YCs were assessed using a self‐reported questionnaire, which could have led to an under‐ or overestimation of YCs. YCs may face difficulties disclosing that they are caregivers because of stigma, which could lead to an underestimation of their prevalence [2, 38]. Anonymous questionnaire surveys may improve the percentage of self‐disclosure in school surveys [66]. Second, this was a cross‐sectional study, and the direction of causality could not be determined. However, the reverse causality in the association between YCs and depression—where depression increases the risk of becoming a YC—is unlikely. Third, we did not collect information on the frequency of care. Future studies are needed to reveal how often care worsens the outcomes for YCs. Lastly, using a single‐item question might not fully capture the multifaceted nature of social support.
5. Conclusions
In conclusion, we found that caring for family members was associated with depressive symptoms and poor school engagement, regardless of the type of care. Our results also showed that a lack of social support mediated the association between YCs and depression. These results suggest that YCs require attention and support.
Funding
This work was supported by the Japan Society for the Promotion of Science (22H03362) and JRP‐LEAD with UKRI (JPJSJRP20211709).
Ethics Statement
The ethics committee at the National Center for Child Health and Development exempted this study from the study protocol review because of the secondary analysis of the anonymous survey data (ethical file number 0016, January 7, 2022).
Conflicts of Interest
The authors declare no conflicts of interest.
Supporting information
Table S1: Young carers, depression, and school engagement.
Table S2: Demographic characteristics and social aspects of young carers according to types of care provided.
Table S3: Sensitivity analysis (mediation analysis of social support and interaction in the association between being a young carer and depression).
Acknowledgments
This study was funded by JSPS KAKENHI (22H03362) and JRP‐LEAD with UKRI (JPJSJRP20211709).
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Table S1: Young carers, depression, and school engagement.
Table S2: Demographic characteristics and social aspects of young carers according to types of care provided.
Table S3: Sensitivity analysis (mediation analysis of social support and interaction in the association between being a young carer and depression).
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.