'Informal caregivers' experienced mental health decline 'akin to divorce' during COVID lockdowns

People who became caregivers during COVID-19 by helping family members, friends or neighbors in need experienced a sharp decline in their own mental health, new research from Lancaster University reveals.

Using the General Health Questionnaire (GHQ) scale—a psychometrically validated and widely used index of psychological distress—researchers studied individual responses to the UK Household Longitudinal Study (Understanding Society).

They looked at 4698 participants from a total of 11 surveys—three before COVID-19 and eight collected between April 2020 and March 2021.

They carefully focused on three groups of people—'existing caregivers' (totaling 349 people who had caring responsibilities for people outside of their home before the pandemic), 'new caregivers' who started helping and continually provided care during the pandemic (1655 individuals), and a group of 'never-caregivers' (2694 respondents).

Results found that the most statistically significant "moments of distress" for new caregivers occurred when national lockdowns were in place. Existing caregivers within the sample experienced a 0.48 point increase in mental deterioration during the third national lockdown, imposed by the Government in January 2021. This measurement indicates worse mental ill-health than men who lose their jobs (measured at 0.41 points on the GHQ scale—for unemployed women, it's 0.60 points), while the death of a partner leads to worse mental health by 0.51 points for women, and 0.53 for men.

Overall, the study finds mental health in the UK fluctuated according to the social restrictions imposed by Government, but the mental health of those who started providing care informally during the pandemic was consistently worse than those who did not provide any informal care at all.

"Our evidence suggests that while social restrictions were put in place to curb infection rates and protect the public from COVID-19, the mental toll this had on informal caregivers was sizeable," explains Chiara Costi, a Ph.D. student from Lancaster University Management School and lead author of the study. "This is the first time, to our knowledge, there has been any focus on the mental health of the vast number of people who became informal caregivers during COVID-19 in the UK."

"While each group of informal caregivers we focused on is different, it is important to note that all respondents had similar levels of mental health before providing informal care."

"When you look at our data, the stay-at-home orders during COVID most certainly harmed the mental health of caregivers across the UK, but had a particularly severe affect on those who took on additional caring roles purely as a result of the pandemic."

"The effect on those who had been caring for people before the pandemic started is also very interesting. While existing caregivers were coping relatively well with the pandemic at the beginning, imposing the third lockdown almost one year after the start of the pandemic looks to have really impacted their mental health when you look at the sharp decline in scores in January 2021."

Data taken from the informal caregivers' responses for the study also shows:

• Existing caregivers are older, on average, than those who have never provided informal care for others, while the new informal caregivers are the youngest group
• Existing caregivers are less likely to be single or live alone, and are more likely to be widowed or divorced when compared to new caregivers or never caregivers
• New caregivers tend to have more dependent children and are more likely to be employed
• Existing caregivers have poorer physical health with greater functional limitations and long-standing illnesses
• White people generally have better mental health than other ethnicities (a decrease of 1.19 GHQ points for existing caregivers and 0.81 points for new caregivers on the GHQ scale)
• Amongst existing caregivers, women tend to have better mental health than men (a decrease of 0.71 GHQ compared to men on the scale)
• Being in paid employment is correlated with better mental health (0.36 GHQ points)

"While all groups we studied have similar demographics in terms of gender, ethnicity and education, existing caregivers are older on average, when compared to new caregivers," said co-author, Dr. Vincent O'Sullivan from the University of Limerick. "This could mean that existing caregivers may have started to provide care earlier to support older parents or relatives, hence having better mental health at the start of the pandemic when compared to those who just started care-giving."

Researchers say their findings should be helpful for policymakers who may look to provide psychological support for new informal care givers.

Co-author, Dr. Eugenio Zucchelli from Autonoma University of Madrid, added, "Our evidence would suggest it is important to look at other forms of support for caregivers that goes beyond financial or respite care."

"Hopefully we won't see a pandemic like the last for quite some time, but for any future public health crisis, it would be important to not overlook those who may be picking up caring duties for the first time—especially if they may be socially isolated and therefore lacking any in-person support or network," adds co-author Professor Bruce Hollingsworth from Lancaster University.

The findings are published in the journal Social Science & Medicine.