CAREGIVER BURDEN AND ITS ASSOCIATION WITH UNMET NEEDS IN SEVERE MENTAL ILLNESS: A CROSS-SECTIONAL STUDY
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Keywords
Severe Mental Illness; Caregiver Burden; Unmet Needs; Camberwell Assessment of Needs; Burden Assessment Schedule.
Abstract
Background: Severe mental illness (SMI) is a chronic and disabling condition that places substantial demands not only on patients but also on their caregivers. In low- and middle-income countries like India, families serve as the primary source of long-term care. Persistent unmet needs among patients may exacerbate caregiver burden, negatively affecting both caregiver well-being and patient outcomes. However, evidence examining the relationship between caregiver burden and unmet needs in SMI remains limited.
Method: This hospital-based cross-sectional study was conducted among 150 patients with severe mental illness attending a tertiary care psychiatry outpatient service and their primary caregivers. Patients aged 18–75 years with a minimum illness duration of two years and a Global Assessment of Functioning score of ≤70 were included. Unmet needs were assessed using the Camberwell Assessment of Needs – Research Version (CAN-R), and caregiver burden was evaluated using the Burden Assessment Schedule (BAS). Sociodemographic and clinical variables of patients and caregivers were recorded. Associations between unmet needs and caregiver burden were examined using non-parametric tests and Spearman’s correlation.
Result: Caregivers experienced a moderate to high level of burden, with a mean BAS score of 26.74 ± 6.33. A significant positive correlation was observed between total unmet needs and caregiver burden (p < 0.05). Higher caregiver burden was also associated with increased cost of medication and greater number of inpatient admissions. Social and financial unmet needs-particularly welfare benefits, money, household management, and daytime activities-were more strongly linked to caregiver burden than clinical needs.
Conclusion: Caregiver burden is closely associated with unmet needs among patients with severe mental illness. Addressing patient needs, particularly in social and financial domains, may reduce caregiver burden and improve overall treatment outcomes. Integrating caregiver-focused interventions and strengthening psychosocial support services are essential components of comprehensive mental health care.
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Dr. Elizabeth John
Assistant Professor, Department of Psychiatry, Dr Somervell Memorial CSI Medical College, Karakonam, Thiruvananthapuram, Kerala, India.
Dr Allwyn George
Assistant Professor, Department of Psychiatry, Dr. Somervell Memorial CSI Medical College, Karakonam, Thiruvananthapuram, Kerala, India.
Dr Christina George
Professor, Department of Psychiatry, Dr. Somervell Memorial CSI Medical College, Karakonam, Thiruvananthapuram, Kerala, India.
