Caregivers of people with severe mental illness in the COVID-19 pandemic
Authors: Jens Peter Eckardt
Journal: The Lancet Psychiatry (2020)

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.1Onwumere J Bebbington P Kuipers E Family interventions in early psychosis: specificity and effectiveness.Epidemiol Psychiatr Sci. 2011; 20: 113-119Crossref PubMed Scopus (86) Google Scholar 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.1Onwumere J Bebbington P Kuipers E Family interventions in early psychosis: specificity and effectiveness.Epidemiol Psychiatr Sci. 2011; 20: 113-119Crossref PubMed Scopus (86) Google Scholar, 2Saunders JC Families living with severe mental illness: a literature review.Issues Ment Health Nurs. 2003; 24: 175-198Crossref PubMed Scopus (247) Google Scholar, 3Gowers SG Bryan C Families of children with a mental disorder.in: Sartorius N Leff J Lopez-Ibor JJ Maj M Okasha A Families and mental disorders: from burden to empowerment. John Wiley & Sons, Hoboken, NJ2005: 127-159Crossref Google Scholar 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,4Yao H Chen JH Xu YF Patients with mental health disorders in the COVID-19 epidemic.Lancet Psychiatry. 2020; 7: e21Summary Full Text Full Text PDF PubMed Scopus (977) Google Scholar 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 caregivers5Holmes EA O'Connor RC Perry VH et al.Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science.Lancet Psychiatry. 2020; (published online April 15.)https://doi.org/10.1016/S2215-0366(20)30168-1Summary Full Text Full Text PDF PubMed Scopus (3645) Google Scholar 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. I declare no competing interests.