Race, role responsibility, and relationship: understanding the experience of caring for the severely mentally ill
The purpose of this study was to identify contextual factors that affect the ability of caregivers to provide necessary supports to mentally ill individuals. Context was defined here as the socially patterned arrangements of peoples' everyday lives and the social and cultural meanings attached to them. Three contextual areas of caregiver burden were explored: race, role responsibility, and relationship between caregiver and the mentally ill individual. Using a stress process model as a guide for our analysis we examined the role of contextual factors, primary stressors and social supports as predictors of several dimensions of caregiver burden: objective financial burden, subjective financial burden, and household disruptions. Analyses were based on interviews with 219 caregivers of persons with severe persistent mental illness who were part of randomized clinical trial of outpatient commitment (OPC) combined with community based treatment. The findings provide evidence of the importance of environmental context in structuring different aspects of caregiver burden, in particular the influence of race and relationship with the client. Parents and spouses experienced more financial burden and household disruptions than other relationships and African American caregivers reported more subjective financial burden than whites. African American caregivers also were more tolerant of client behaviors than whites. Instrumental social support and help with the client were predictors of caregiver burden. The latter was interpreted as evidence of a support mobilization effect. © 2000 JAI Press Inc.
