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The emotional and mental health needs of young carers: what psychiatry can do

  • Roswitha Dharampal (a1) and Cornelius Ani (a2)


Aims and method

To review the literature on the emotional and mental health needs of young carers of parents with mental illness and the extent to which such needs are recognised and supported by professionals. Three databases were systematically searched from 2008 to 2018, and five studies met the inclusion criteria.


The key findings were that young caregivers had a significantly higher dose-response mortality risk than their peers; were at increased risk of mental health difficulties, especially where the ill family member was a parent and had mental illness or misused substances; were overlooked by professionals owing to a lack of awareness; but could derive benefits from their caring role when appropriately supported.

Clinical implications

Young carers are at increased risk regarding emotional and mental health needs; this risk could be mitigated by professionals recognising the young carer's role and including them in their parent's treatment plan.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Correspondence to R. Dharampal (


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Declaration of interest: None.



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1Sprung, S, Laing, M. Young carer awareness and referral. Br J Community Nurs 2017; 22(8): 398406.
2The Children's Society. Hidden from View: The Experiences of Young Carers in England. The Children's Society, 2013.
3The Association of Directors of Adult Social Services (ADDAS), The Children's Society, The Association of Directors of Childrens’ Services (ADCS). Working Together to Support Young Carers and their Families: A Template for Local Memorandum of Understanding [MoU] between Statutory Directors for Children's Services and Adult Social Services. ADDAS, The Children's Society, ADCS, 2012.
4Office for National Statistics. 2001 Census: General Report for England and Wales. ONS, 2005.
5Office for National Statistics. 2011 Census: Key Statistics for England and Wales. ONS, 2012.
6Becker, S. Global perspectives on children's unpaid caregiving in the family: research and policy on ‘young carers’ in the UK, Australia, the USA and Sub-Saharan Africa. Global Soc Policy 2007; 7: 2350.6.
7Dearden, C, Becker, S. Young Carers in the UK: The Report. Carers UK and The Children's Society, 2004.
8Aldridge, J, Becker, S. Children caring for parents with mental illness. In Perspectives of Young Carers, Parents and Professionals. The Policy Press, 2003.
9Becker, S, Aldridge, J, Dearden, C. Young Carers and their Families. Blackwell Science, 1998.
10Dearden, C, Becker, S. Young Carers in the United Kingdom: A Profile. Carers National Association, 1998.
11Department for Children, Schools and Families. The Longitudinal Survey of Young People in England. Department for Education, 2010.
12Dearden, C, Becker, S. The experiences of young carers in the UK: the mental health issues. Ment Health Care 1999; 2: 273–6.
13Cooklin, A. ‘Living upside down’: being a young carer of a parent with mental illness. Adv Psychiatr Treat 2010; 16: 141–6.
14The Children's Commissioner for England. Estimating the Prevalence of the ‘Toxic Trio’. Evidence from the Adult Psychiatric Morbidity Survey. Vulnerablity Technical Report 2. Children's Commissioner for England, 2018.
15Hearle, J, Plant, K, Jenner, L, Barkla, J, McGrath, J. A survey of contact with offspring and assistance with childcare among patients with psychotic disorders. Psychiatr Serv 1999; 50: 1354–6.
16Ahern, K. At-risk children: a demographic analysis of the children of clients attending mental health community clinics. Int J Ment Health Nurs 2003; 12: 223–38.
17Nicholson, J, Biebel, K, Williams, VF, Katz-Levy, J. The prevalence of parenthood in adults with mental health illness: implications for state and federal policymakers, programs, and providers. In Mental Health, United States, 2002 (eds Manderscheid, R, Henderson, M): 120–37. United States Department of Health and Human Services, 2004.
18Maybery, DJ, Reupert, AE, Patrick, K, Goodyear, M, Crase, L. Prevalence of parental mental illness in Australian families. Psychiatr Bull 2009; 33: 22–6.
19Parker, G, Beresford, B, Clarke, S, Gridley, K, Pitman, R, Spiers, G, et al. Technical Report for SCIE Research Review on the Prevalence and Incidence of Parental Mental Health Problems and the Detection, Screening and Reporting of Parental Mental Health Problems. Social Policy Research Unit: University of York, 2008.
20Day, C. Parental mental health & impact on children & young people. Presentation at Hearing Young Voices Conference, 2019.
21Stamatopoulos, V. One Million and counting: the hidden army of young carers in Canada. J Youth Stud 2015; 18(6): 809–22.
22Fraser, E, Pakenham, K. Evaluation of a resilience-based intervention for children of parents with mental illness. Aust NZ J Psychiatry 2008; 42: 1041–50.
23Australian Infant, Child, Adolescent and Family Mental Health Association. Children of Parents Affected by a Mental Illness, Scoping Project Report. Mental Health and Special Programs Branch, Department of Health and Aged Care, 2001.
24Farrell, G, Handley, C, Hanke, A, Hazelton, M, Josephs, A. The Tasmanian Children's Project Report: The Needs of Children and Adolescents with a Parent/Carer with a Mental Illness. University of Tasmania, 1999.
25Mowbray, C, Oyserman, D, Bybee, D, MacFarlane, P, Rueda-Riedle, A. Life circumstances of mothers with a serious mental illness. Psychiatr Rehabil J 2001; 25(2): 114–23.
26Rutter, M, Quinton, D. Parental psychiatric disorder: effects on children. Psychol Med 1984; 14: 853–80.
27Thomas, A, Forehand, R, Neighbors, B. Change in maternal depressive mood: unique contributions to adolescent functioning over time. Adolescence 1995; 30(117): 4352.
28Davies, P, Windle, M. Gender-specific pathways between maternal depressive symptoms, family discord, and adolescent adjustment. Dev Psychol 1997; 33: 657–68.
29Pakenham, K, Cox, S. The effects of parental illness and other ill family members on the adjustment of children. Ann Behav Med 2014; 48: 424–37.
30McAndrew, S, Warne, T, Fallon, D, Roran, P. Young, gifted, and caring: a project narrative of young carers, their mental health, and getting them involved in education, research and practice. Int J Ment Health Nurs 2012; 21: 12–9.
31Rubovits, P. Project CHILD. An intervention programme for psychotic mothers and their young children. In Parental Psychiatric Disorder. Distressed Parents and their Families (eds. Gopfert, M, Webster, J, Seeman, M): 161–9. Cambridge University Press, 1996.
32Beardslee, WR, Bemporad, J, Keller, MB, Klerman, GL. Children of parents with major affective disorder. A review. Am J Psychiatry 1983; 140: 825–32.
33Royal College of Psychiatrists. Parents as Patients: Supporting the Needs of Patients who are Parents and Their Children. College Report CR164. RCPsych, 2011.
34Weissman, M, Wickramaratne, P, Nomura, Y, Warner, V, Pilowsky, D, Verdeli, H. Offspring of depressed parents: 20 years later. Am J Psychiatry 2006; 163(6): 1001–8.
35Weissman, M, Obianuju Berry, O, Warner, V, Gameroff, M, Skipper, J, Talati, A, et al. A 30-year study of 3 generations at high risk and low risk for depression. JAMA Psychiatry 2016; 73(9): 970–7.
36Wolpert, M, Hoffman, J, Martin, A, Fagin, L, Cooklin, A. An exploration of the experience of attending the Kidstime programme for children with parents with enduring mental health issues: parents’ and young people's views. Clin Child Psychol Psychiatry 2014; 20(3): 406–8.
37Moher, D, Liberati, A, Tetzlaff, J, Altman, DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009; 151: 264–9.
38Stamatopoulos, V. The young carer penalty: exploring the costs of caregiving among a sample of Canadian youth. Online J Child Youth Serv 2018; doi:10.1080/0145935X.2018.1491303.
39Tseliou, F, Rosato, M, Maguire, A, Wright, D, O'Reilly, D. Variation of caregiver health and mortality risks by age: a census-based record linkage study. Am J Epidemiol 2018; 187(7): 1401–10.
40Pakenham, K, Bursnall, S, Chiu, J, Cannon, T, Okochi, M. The psychosocial impact of caregiving on young people who have a parent with an illness or disability. Rehabil Psychol 2006; 51: 113–26.
41Hirst, M. Care distress: a prospective, population-based study. Soc Sci Med 2005; 61(3): 697708.
42Cuijpers, P. Depressive disorders in caregivers of dementia patients: a systematic review. Aging Ment Health 2005; 9(4): 325–30.
43Christakis, N, Allison, P. Inter-spousal mortality effects: care-giver burden across the spectrum of disabling disease. In Health at Older Ages: the Causes and Consequences of Declining Disability Among the Elderly (eds. Cutler, D, Wise, D): 455–77. University of Chicago Press, 2009.
44Joling, KJ, Van Hout, HP, Schellevis, FG, van der Horst, HE, Scheltens, P, Knol, DL, et al. Incidence of depression and anxiety in the spouses of patients with dementia: a naturalistic cohort study of recorded morbidity with a 6-year follow-up. Am J Geriatr Psychiatry 2010; 18(2): 146–53.
45Lopez, J, Lopez-Arrieta, J, Crespo, M. Factors associated with the positive impact of caring for elderly and dependent relatives. Arch Gerontol Geriatr 2005; 18(2): 146–53.
46Wolff, JL, Dy, SM, Frick, KD, Kasper, JD. End-of-life care: findings from a national survey of caregivers. Arch Intern Med 2007; 167(1): 40–6.
47O'Reilly, D, Connolly, S, Rosato, M, Patterson, C. Is caring associated with an increased risk of mortality? A longitudinal study. Soc Sci Med 2008; 67(8): 1282–90.
48Brown, SL, Smith, DM, Schulz, R, Kabeto, MU, Ubel, PA, Poulin, M, et al. Caregiving behaviour is associated with decreased mortality risk. Psychol Sci 2009; 20(4): 488–94.
49Fredman, L, Cauley, JA, Hochberg, M, Ensrud, KE, Doros, G. Mortality associated with caregiving, general stress and caregiving-related stress in elderly women: results of caregiver-study of osteoporotic fractures (SOF). J Am Geriatr Soc 2010; 58(5): 937–43.
50Ramsay, S, Grundy, E, O'Reilly, D. The relationship between informal caregiving and mortality: an analysis using the ONS Longitudinal Study of England and Wales. J Epidemiol Community Health 2013; 67(8): 655–60.
51Roth, DL, Haley, WW, Hovater, M, Perkins, M, Wadley, VG, Judd, S. Family caregiving and all-cause mortality: findings from a population-based propensity-matched analysis. Am J Epidemiol 2013; 178(10): 1571–8.
52O'Reilly, D, Rosato, M, Macgure, A. Caregiving reduces mortality risk for most caregivers: a census-based record linkage study. Int J Epidemiol 2015; 44(6): 1959–69.
53Millenaar, J, van Vliet, D, Bakker, C, Vernooij-Dassen, M, Koopmans, R, Verhey, F, et al. The experiences and needs of children living with a parent with young onset dementia: results from the NeedYD study. Int Psychogeriatr 2014; 26(12): 2001–10.
54Leu, A, Frech, M, Jung, C. Young carers and young adult carers in Switzerland: caring roles, ways into care and the meaning of communication. Health Soc Care Community 2017; 26: 925–34.
55Leu, A, Frech, M, Jung, C. ‘You don't look for it’ – A study of Swiss Professionals’ awareness of young carers and their support needs. Health Soc Care Community 2018; doi:10.1111/hsc.12574.
56Cooklin, A, Hindley, P. Young Carers and COPMI. Improving the response to Children of Parents with Mental Illness by Health and Social Care Services. NHS England Round Table Presentation to the Council of the Royal College of Psychiatrists, 2015.
57Mechling, B. The experiences of youth serving as caregivers for mentally ill parents a background review of the literature. J Psychosoc Nurs 2011; 49(3): 2833.
58Gray, B, Robinson, C, Seddon, D. Invisible children: young carers of parents with mental health problems – the perspectives of professionals. Child Adolesc Ment Health 2008; 13(4): 169–72.
59Aldridge, J. The experiences of children living with and caring for parents with mental illness. Child Abuse Rev 2006; 15: 7988.
60Sieh, DS, Meijer, AM, Oort, FJ, Visser-Meily, JMA, Van der Leij, DAV. Problem behaviour in children of chronically ill parents: a meta analysis. Clin Child Family Psychol Rev 2010; 13: 384–97.
61Grant, G. Young people supporting parents with mental health problems: experiences of assessment and support. Health Soc Care Community 2008; 16(3): 271–81.
62Cooklin, A. Promoting children's resilience to parental mental illness: engaging the child's thinking. Adv Psychiatr Treat 2013; 19: 229–40.
63Ali, L, Ahlstrom, B, Krevers, B, Sjostrom, N, Skarsater, I. Support for young informal carers of persons with mental illness: a mixed-method study. Issues Ment Health Nurs 2013; 34: 611–8.
64Dearden, C, Aldridge, J. Young carers: needs, rights and assessments. In The Child's World: The Comprehensive Guide to Assessing Children in Need (2nd edn, ed. Horwath, J): 214–28. Jessica Kingsley Publishers, 2010.
65Bilsborough, S. What we want from adult psychiatrists and their colleagues: ‘Telling it like it is’. In Parental Psychiatric Disorder: Distressed Parents and their Families (eds. Gopert, M, Webster, J, Seeman, M): 37. Cambridge University Press, 2004.
66McDougall, E, O'Connor, M, Howell, J. ‘Something that happens and stays at home’: an exploration of the lived experience of young carers in Western Australia. Health Soc Care Community 2018; 26: 572–80.
67Leu, A, Becker, S. A cross-national and comparative classification of in-country awareness and policy responses to ‘young carers’. J Youth Stud 2017; 26(6): 750–62.


The emotional and mental health needs of young carers: what psychiatry can do

  • Roswitha Dharampal (a1) and Cornelius Ani (a2)


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The emotional and mental health needs of young carers: what psychiatry can do

  • Roswitha Dharampal (a1) and Cornelius Ani (a2)
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