The impact of providing care for physical health in severe mental illness on informal carers: a qualitative study

Background

People with severe mental illness (SMI) e.g., schizophrenia are at a substantially higher risk of premature death, in that they die 10–20 years earlier than the general population. Cardiovascular disease (CVD) and diabetes are the main potentially avoidable contributors to early death.

Aims

To explore the impacts of providing care for physical health in severe mental illness on informal carers.

Method

Thematic analysis of semi-structured interviews with eight informal carers of people with SMI in the UK national health services.

Results

Informal carers played an active part in the management of the patient’s conditions and shared their illness experience. Carers provided both emotional and practical involvement and informal carers’ own lives were affected in ways that were sometimes deeply profound. Informal carers were involved in both ‘looking after’ the patient from the perspective of doing practical tasks such as collecting dispensed medication from a community pharmacy (caring for) and managing feelings and emotions (caring about).

Conclusions

Caring for the physical health of someone with SMI can be understood as having two dimensions - 'caring for' and 'caring about'. There is a bidirectional relationship between these two dimensions, and both have a cost for the informal carer. With appropriate support informal carers could be more actively involved at all stages of care with an awareness that carers may minimise the information they share about their own needs and impacts of their role to spare the person they care and themselves any distress.