Team Finds Pathways to Improve Mental Health for Family Caregivers

According to the Centers for Disease Control and Prevention, more than 50 million people in the United States are family caregivers, providing unpaid care for older adults or loved ones with chronic illness or disability. It is widely known that family caregivers face higher levels of stress, burnout, anxiety, and depression, along with challenges accessing mental health care to address these concerns. Although previous research has explored barriers to mental health care at the individual and interpersonal levels, less work has been done on the bigger picture: how organizational, community, and policy levels produce and sustain access challenges. That’s why researchers from the Texas CEAL Regional Team set out to study how the different contexts of a caregiver’s life shape their ability to access mental health supports.

The researchers conducted interviews with Houston-area family caregivers and health care providers (both community health workers [CHWs] and mental health professionals). The team used a socioecological model — a framework for studying the interplay between people and the different contexts in which they live — to develop the interview questions and analyze the responses from interviews with 51 participants.

The researchers’ findings

• At the individual level, some barriers to mental health care access included competing responsibilities, language barriers, and financial strains. Within families, some caregivers reported that family members may minimize the need for help.
• Caregivers often face unstable support programs and long wait times (organizational level), as well as stigma and a lack of affordable services (community level).
• At the policy level, participants noted that coverage for mental health services for caregivers is scarce.
• These challenges to accessing mental health support operate — and reinforce one another — across the different contexts of a caregiver’s experience.

The evidence-based opportunities 

• The study points to the need for coordinated strategies that go beyond individual caregivers seeking more help to address systems-level challenges.
• When health care providers offer mental health care that is culturally tailored and rises to the demanding realities of caregivers’ lives, including meeting caregivers where they are, care can be more effective.
• CHWs can play a role in helping caregivers navigate systems. Training them in mental health care navigation can go a long way toward getting family caregivers the mental health support they may need over an extended period of time.