Chapter 1
The Problems and Its setting
Background of the Study
Taking care of someone with mental illness can be very demanding in terms of emotions,
thoughts, and physical effort. Caregivers, who are often family members or close friends, have an
important role in supporting and looking after those dealing with mental health issues. Mental illnesses
can cover a wide range of conditions, such as depression, anxiety disorders, schizophrenia, bipolar
disorder, and more. The responsibilities of caregiving go beyond dealing with the symptoms and
behaviors of the mentally ill individuals. Caregivers often face challenges like dealing with social stigma,
feeling isolated, and having limited resources. It is important to understand how this caregiving role
affects the mental health of those providing the care so that we can find ways to support them better.
(Alliance, 2006)
According to recent studies, an increasing number of people experience mental health disorders
(Fernando, 2014; Bruffaerts et al., 2015; Polanczyk et al., 2015; Hanna et al., 2018). Due to a global
deinstitutionalization of the treatment of mental illnesses, only a low proportion of those suffering from
mental illnesses are admitted to hospitals (WHO, 2017). Of those who are hospitalized, ∼30–50%
experience a relapse of symptoms within the first 6 months and 50–70% in the first 5 years after being
discharged (Chang and Chou, 2015; Ali et al., 2017; Sadock et al., 2017).
However, as family and spousal caregivers live with patients and are usually the first to recognize
behavioral changes, they play an increasingly important role in supporting and rehabilitating those who
suffer from mental health illnesses.
Statement of the Problem
The main problem of this study is to determine the psychological effects of caring for mentally
patients on caregivers. This study pursues to answer the following questions:
1. What are the most common psychological effects experienced by caregivers of mental health
patients?
2. What coping mechanisms do caregivers employ to manage the psychological effects
associated with caregiving for mental health patients?
3. How does caring for mental health patients affect the caregiver’s psychological health?
Research Hypothesis
Null hypothesis (Ho:) There is no significant differences
Scope and Delimitation
Significance of the Study
This research study aims to:
To help the researchers and the healthcare providers to know the factors influencing the
psychological aspect of caregivers caring for mental health patient
To help the researchers contribute to psychiatric nursing by providing valuable insights into
the psychological effects experienced by the caregivers of individuals with mental health
conditions
To allow the researchers to identify the coping mechanisms and support systems employed
by caregivers to manage these challenges
To help the researchers provide awareness within households about the challenges faced by
the caregivers of mental health patients
Importance of the Study
Definition of Terms
Psychological Effects – refers to the impact that various factors, such as events, experiences, substances,
or conditions, have on an individual's mental and emotional well-being
Caregiver- someone who provides for the needs of an individual who is ill or cannot provide for their
own needs.
Mental Health Patient- an individual who seeks or receives treatment, care, or support for mental health
issues or disorder
Chapter 2
Review of Related Literature and Studies
Related Literature
The shift in mental health treatment philosophy from institutions to their homes had a profound,
but rarely acknowledged, effect on the family. (Thupayagale-Tshweneagae, 2007)
According to (Cemental, 2022), caring for someone else — professionally or not — can
significantly impact your life. As you focus on someone else, you may forget your own needs. But you
can also feel extremely fulfilled. Caregiving can have both positive and negative effects on your overall
health, highlighting the importance of finding balance as you care for others.
Mental illness is a chronic illness and it necessitates family caregiving throughout the lifespan of
the relative living with mental illness. Hence, the family caregivers shoulder a large share of the long-
term responsibilities. Research suggests that mental illness is a devastating illness for both the caregiver
and the patient (Moahi & Seloilwe, 2007, 2006)
Caregiving affects the family in various ways. Caring for relatives living with mental illness
affects the physical, psychological, and socio-economic well-being of the caregivers, as well as their
capacity to cope with and adjust to those circumstances. Without support, they end up compromising their
health and well-being ((Jack-Ide, 2013)
Coping mechanisms are strategies that help people deal with stress and uncomfortable emotions.
Whether you realize it or not, you are using coping mechanisms regularly. These behaviors can help you
positively cope with stress or can sometimes be harmful. (Aubrey Bailey, 2022). It is the process by
which an individual contends with or deals with a situation to alleviate, relieve, or remove stress.
(Middleton, 2014). Coping enables the individual to remain unaware of an unpleasant reality as if it did
not exist. Some caregivers used denial and blame.
An inability to cope has been shown to present in physical symptoms like sleeplessness, unrest, and
anger. This can hurt the caregivers' mental health. According to Wilkinson and Lynn (2005:122-130), the
course of the relative's illness shapes the caregiver's experience.
When encountering a stressful situation, a person may assess the relevancy of the encounter,
evaluate whether it is a threat, and bring to mind a potential response to the threat. (Carver & Lazarus &
Folkman, 1989 & 1984). Then, the person makes decisions to utilize certain strategies to reduce the
discrepancy between the stressful demands and personal resources if any (Lazarus & Folkman, 1984).
Coping strategies adopted by caregivers can influence the ways they respond to stressors and
therefore affect the quality of life for both them and the patients (Kristofferzon & Taylor & Stanton, 2011,
2007). The classical model of coping holds that in stressful situations, individuals may adopt: (1)
emotion-based coping strategies to control their feelings and emotions or (2) problem-focused coping
strategies to reduce stressors by taking action and seeking support (Lazarus & Folkman, 1984).
Related Studies
According to (Psychiatry, 2014) the caregivers caring for their patient with mental illness feel
stressed, anxious and low, since the illness tends to be chronic and demanding. In the long run, there may
occur burnout and emotional exhaustion. The caregivers feel isolated from the society, both due to
restriction of their social and leisure activities, as well as the social discrimination and stigma attached to
the mental illnesses. Care giving for mentally ill patients impacts on various aspects of a caregiver’s life,
including his or her physical, emotional and psychological health. (Nazish Imran, 2010)
According to various studies ((Lefley, al, & Reay, 1996, 2004, 2000) family caregivers
usually experience feelings of fear, confusion, stress, guilt, shame, self-blame, depression,
nervousness, and irritability.
A mentally ill family member usually causes psychological and emotional disturbances
for the whole family. The family caregivers have to live in disgrace because they have a mentally
ill family member (Horrocks & Chan, 2006, 2005)
The mental health benefits of social support were mainly evident during stressful periods.
(Stanton, 2007)reported that social support reduces psychological distress and contributes to
physical health and survival. The caregivers felt isolated from society because of the disruptions
in their social lives as they had to care for the patient. Social discrimination was also caused by
the stigma attached to mental illness. Stigmatization and social isolation were prevalent
experiences among the family caregivers who had to contend with social relationships that were
strained by a lack of knowledge and negative attitudes about mental illness (Shamsaei, 2013).
Some statements by caregivers were depictive of loneliness.
Gaps in the Review by the Present Study Bridged
