Caregivers of people with severe mental illness in the COVID-19 pandemic

Studies have shown that severe mental illness is often associated with substantial pressures on family members of the person with mental illness, especially those individuals who have a caregiving role. Caring for someone with a severe mental health disorder can compromise the caregiver's own physical and psychological health, and can lead to psychological distress, anxiety, depression, and post-traumatic stress disorder.¹ There have been reports of caregivers experiencing loss and grief, sadness, fatigue, emotional exhaustion, sleep disturbance, burnout, blame, guilt, social isolation, and financial hardship, combined with the consequences of stigma attached to mental illness.1, 2, 3 However, families can play an important role in supporting people with mental illness in the community, during their treatment, and are a key part of their social network. Unfortunately, the circumstances of caregivers are not always a focus of attention of mental health services worldwide.

The current COVID-19 pandemic can affect not only people with mental health disorders,⁴ but also their family and caregivers. Urgent attention is needed to ensure that the appropriate support is provided. The pandemic could lead to substantial deterioration of family functioning caused by the unimaginable pressure inflicted by COVID-19 restrictions and precautions; in particular, the increased pressure on caregivers might result in an imbalance in the demand for resources and disputes between family members. As caregiving is not a free resource, having a mental illness during a global pandemic could have a huge effect on the entire family system—eg, financially, socially, and interpersonally—especially when combined with the impact of larger-scale effects of the pandemic on socioeconomic conditions. There is scarce research on the effect of COVID-19 on caregivers⁵ and I am concerned that the current public health messaging might be leaving out this important at-risk population who are underutilised in the treatment of people with mental illness. To care for patients with mental health disorders on a global scale during this pandemic, the importance of caregivers needs to be recognised more than ever before. The health-care community cannot afford to lose the aid of caregivers, engagement with whom offers a unique opportunity to ensure healthy lives and overall wellbeing for people with mental health disorders.