Caregiver burden takes a toll on mental health
Canada’s health care system is increasingly reliant on informal or voluntary caregivers (those family members and friends who provide a variety of supports without remuneration) to support the needs of those with chronic illnesses, those with mental illness, and our seniors. These caregivers’ economic contribution in Canada was an estimated $25 billion in 2009,1 $5 billion of which can be attributed to providing support for those living with mental illness.2 A recent survey showed that 8.1 million Canadians aged 15 or older provided care to a family member during the year preceding the survey.3 While individuals from various demographics take on this role, voluntary caregivers are more often women (75%) and many belong to the expanding “sandwich generation”.4 Canada’s aging demographic with its likely increases in rates of dementia and chronic illnesses suggests that these numbers will increase in the near future.3
The role of caregiver can be a fulfilling experience. There are, however, challenges associated with keeping up this role for long periods of time while maintaining everyday activities. These individuals often need to balance their role as caregiver and their family’s needs, or caregiving and paid employment.5 Many find themselves in situations where they lack the resources or skills to cope with various caregiving demands.6
These demands can take a toll on their mental and physical health.7 Caregivers of individuals living with mental illnesses or experiencing mental health challenges, for instance, often report negative physical and emotional effects due to the lack of recognition and support.8 They also report being anxious or worried about their responsibilities, and sacrifice time spent with their families or on their employment.6 Furthermore, caregivers have increased levels of stress and depression as well as lower levels of subjective well-being.9 These stressors can manifest as various illnesses, including “burnout”. Very high levels of stress are reported by approximately 16% of caregivers,3 while failure to support caregivers has been shown to undermine mental health across the population, including the person receiving care.10 These experiences are not unique to those supporting individuals living with mental illnesses, as parallels can be drawn to the experience of caregivers of those suffering from other diseases.
The challenge is that caregivers need to know when and where to seek help, how to take care of themselves, and what information sources and resources are available to provide them with respite. The Mental Health Commission of Canada has released guidelines and recommendations to better support caregivers to help them maintain their mental and physical well-being.2 Similarly, the Mental Illness Caregivers Association in conjunction with Ottawa Public Health, Canadian Mental Health Association and CPHA are developing a hands-on guide for caregivers of those living with mental illness or experiencing mental health challenges. Such supports are needed for all caregivers.
Informal caregivers are essential to sustaining our health care system,10 as they care for individuals at home who would otherwise need professional interventions. For as long as the need for informal care exists, the needs of the voluntary caregiver must also be addressed.4
- Hollander MJ, Liu G, Chappell NL. 2009. Who Cares and How Much? The Imputed Economic Contribution to the Canadian Healthcare System of Middle-Aged and Older Unpaid Caregivers Providing Care to The Elderly. Healthcare Q 2009;12(2):42–49.
- Mental Health Commission of Canada (MHCC). 2015. Caregiving. Calgary: the Commission. Available at: www.mentalhealthcommission.ca/English/issues/caregiving (Accessed May 13, 2015).
- Sinha M. 2013. Portrait of Caregivers 2012. Statistics Canada Catalogue no. 89-652-X-No.001. Ottawa. Industry Canada, 21 pp. Available at: www.statcan.gc.ca/pub/89-652-x/89-652-x2013001-eng.pdf (Accessed May 15, 2015).
- Canadian Mental Health Association, 2004. Caregiver Support and Mental Health. Available at: www.cmha.ca/public-policy/caregiver-supporty-and-mental-health/#VVYnFfDuGYk (Accessed May 15, 2015).
- The Canadian Centre for Elder Law, 2010. The British Columbia Law Institute. Care/Work: Law Reform to Support Family Caregivers to Balance Paid Work and Unpaid Caregiving. British Columbia Law Institute. 124pp. Available at: www.bcli.org/sites/default/files/FamilyCaregivingReport.pdf (Accessed May 22, 2015).
- Pinquart M, Sörensen S. 2003. Differences Between Caregivers and Noncaregivers in Psychological Health and Physical Health: A Meta-Analysis. Psychol Aging 18(2):250-67.
- Mental Health Commission of Canada (MHCC). 2015. Informing the Future: Mental Health Indicators for Canada. Calgary: MHCC. 20pp. Available at: www.mentalhealthcommission.ca/English/system/files/private/document/MHCC_MentalHealthIndicators_Jan2015_ENG.pdf (Accessed May 12, 2015).
- The standing Senate Committee on Social Affairs, Science and Technology. 2006. Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada. Ottawa: Parliament of Canada. Available at: www.parl.gc.ca/Content/SEN/Committee/391/soci/rep/rep02may06part1-e.htm#_Toc133223023 (Accessed May 22, 2015).
- MacCourt P, 2013. Family Caregivers Advisory Committee, Mental Health Commission of Canada. National Guidelines for a Comprehensive Service System to Support Family Caregivers of Adults with Mental Health Problems and Illnesses. Calgary: Mental Health Commission of Canada. 62pp. Available at: www.mentalhealthcommission.ca/English/system/files/private/document/Caregiving_MHCC_Family_Caregivers_Guidelines_ENG.pdf (Accessed May 7, 2015).
- Romanow RJ,2002. Commission on the Future of Health Care in Canada. Building on values: The future of health care in Canada. Saskatoon: the Commission. 392pp. Available at: publications.gc.ca/site/archivee-archived.html?url=http://publications.gc.ca/collections/Collection/CP32-85-2002E.pdf (Accessed May 15, 2015).