Do Caregivers of Those with Mental Illness Differ By Caregiver Race or Relationship to Recipient?

Background/Purpose:

Caregivers have negative physical and psychological health outcomes   Research about caregivers of those with mental illness focuses on parents who care for children, a small portion of the overall population of those caring for individuals with mental illness.  Little is known about within group differences among caregivers of individuals with mental illness.

This study examines the potential for data from the Behavioral Risk and Surveillance to provide an analysis of within group differences among caregivers of those with mental illness, attributed to whom the caretaker provides care, and/or the demographic characteristics of the caregiver.

Methods:

We used cross-sectional data from the Behavioral Risk Factor Surveillance Survey (BRFSS) in 46 states between 2015-2017 that included the optional caregiving module. We compared mental illness caregivers based on the care recipient (someone for whom the caretaker was a parent, someone of the same age or older (spouse, parent, grandparent), and other family members) and between mental illness caregivers and other caregivers. The dependent variable was both a continuous and dichotomous ( >= 14) number of days of poor mental health quality of life (MHQOL).

We used survey adjusted and weighted analyses of the descriptive results, comparing BRFSS respondents by their mental illness caregiving status (compared to all other caregivers) with survey adjusted chi-square tests for categorical/binary variables and ANOVA for continuous variables. We tested the hypothesis that mental illness caregivers had lower mental health quality of life than other caregivers with linear and logistic regression models adjusted for demographic, socioeconomic status, and health care access.

Results:

While non-Hispanic white race mental illness caregivers were more likely to be caring for a child of their own, non-Hispanic black race mental illness caregivers were more likely to be caring for other/non-fam/sibling recipients. Parents of children with mental illness most frequently wanted service referrals, counseling and support groups.

Parents caring for children with mental illness had a 2-fold higher odds of 14+ days of poor MHQOL compared to mental illness caregivers than for other family (nonfam/other fam/sibling). There were stark racial differences in MHQOL among child caregivers: Hispanic child caregivers had significantly lower odds of poor MHQOL compared to non-Hispanic white child caregivers. On the other hand, Non-Hispanic Other race child caregivers had 8-times higher odds of poor MHQOL than Non-Hispanic White caregivers.

Conclusions/Implications:

Our results add substantially to previous studies that reveal racial/ethnic differences in the impact of caregiving.  Specifically, our findings suggest that there are differences in the target of caretaking between these groups (for instance, caretaking a child versus a sibling) that may or may not be related to the differential impact of providing care.  Further exploration of these differences is warranted, as they may be related to the intergenerational transmission of mental illness and/or capacity within specific communities to tolerate caretaking responsibilities.