Background: Family members of persons with severe and persistent mental illness (SPMI) describe significant responsibility over time and extensive caregiving burden. Positive aspects of caring for relatives with SPMI are also increasingly recognized. However, current research fails to differentiate between the experiences and perspectives of parents and adult siblings who assume caregiving responsibilities, whether positive or negative.

Purpose: This study aimed to investigate the differences, including gains and losses, between parent and sibling caregivers as a consequence of caring for their adult children/siblings with SPMI.

Methods: A sample of 137 caregivers of persons with SPMI interviewed in the 1992-1993 Family Impact Study conducted in New York City was included in this study. Composite scales for caregiver's well being, pride, depressive mood, and burden were created to measure emotional gains and loss associated with caregiving. Parallel multiple regression analyses were conducted for parent and sibling caregivers to compare the risk and protective factors predicting well being, pride, burden, and depressive mood between the subgroups.

Results: Findings confirmed that different sets of risk and protective factors predict emotional response for these two groups of caregivers. Higher income, lower levels of grief, less perceived family stress, and less substance use significantly predicted well-being among parents. Grief predicted well being, burden, and depressive mood for parents but not for siblings. Overall sibling caregivers reported more burden than parent counterparts. Regular assistance with personal care for the relative with SPMI was associated with decreased pride and increased burden for sibling caregivers but not for parents. In contrast, stigma predicted more pride and less burden for sibling caregivers than for parents.

Conclusion: Parent and sibling caregivers of persons with SPMI respond somewhat differently to the caregiving role. The findings will be analyzed in the context of available literature on caregiving and SPMI. The implications for future research, clinical and community practice, and policy will then be presented and discussed.