The role of family caregiving in the management of individuals with mental illnesses and the outcome of family-based interventions for mental illnesses in China: a scoping review

Abstract

The effects of China's rapid economic development and urbanisation on family caregivers' responsibilities for providing essential practical, social, and psychological support to family members with mental illnesses are unclear. This scoping review identified 176 relevant studies published from 1 January 2000 to 31 December 2023 in six English-language and three Chinese-language databases. Most studies focus on family caregiving for individuals with schizophrenia (63 studies), autism (40 studies), or dementia (39 studies). Family caregiving—subclassified as informational, concrete, or psychological—was beneficial both for patients and their family members, but providing support often necessitated substantial sacrifices by family caregivers, many of whom experience psychological distress and financial difficulties. The type and intensity of the support provided are influenced by the severity of the patient's symptoms, financial and other resources of the patient's family, community members' beliefs about mental illnesses, and the local availability of mental health and social welfare services. Results from intervention studies indicate that different methods of enhancing family caregiving improved outcomes for individuals with mental illnesses. However, the methodological quality of the intervention studies was poor, and most of the studies were conducted in inpatient settings, so the benefits of these family-based strategies remain uncertain. Rapid economic development and urbanisation in China are resulting in fundamental changes in the relative responsibilities of different stakeholders for providing social welfare services—individuals, families, communities, and governmental agencies. Understanding and enhancing the role that families play in the support of community members with mental illnesses will require improving the quality of research about this issue, expanding the range of mental health conditions considered, and, most importantly, developing a dynamic overarching theoretical framework that integrates the many factors influencing ongoing changes in the structure and functioning of Chinese families.