title: The experience of caregivers of people living with serious mental disorders: a study from rural Ghana.
abstract: BACKGROUND
  Families and friends who give care to people with mental disorders (MDs) are affected in a variety of ways and degrees. The interplay of caregiving consequences: poverty, discrimination and stigma, lack of support from others, diminished social relationships, depression, emotional trauma, and poor or interrupted sleep are associated caregiver burden.
  
  
  OBJECTIVE
  The burden of care on caregivers of people living with MDs was assessed in two districts located in the middle part of Ghana. Coping strategies and available support for caregivers of MDs were also assessed.
  
  
  METHODS
  A qualitative study was carried out involving 75 caregivers of participants with MDs registered within the Kintampo Health and Demographic Surveillance Systems. Data were gathered from caregivers about their experiences in providing care for their relations with MDs.
  
  
  RESULTS
  Caregivers reported various degrees of burden, which included financial, social exclusion, emotional, depression, and inadequate time for other social responsibilities. Responsibilities around caregiving were mostly shared among close relatives but to a varying and limited extent. Religious prayers and the anticipation of cure were the main coping strategies adopted by caregivers, with expectation of new treatments being discovered.
  
  
  CONCLUSIONS
  Emotional distress, stigma, financial burden, lack of support networks, social exclusion, health impact, and absence of decentralised mental health services were experienced by family caregivers. These findings highlight the need for interventions to support people with MDs and their caregivers. This might include policy development and implementation that will decentralise mental health care provision including psychosocial support for caregivers. This will ameliorate families' financial and emotional burden, facilitate early diagnosis and management, reduce travel time to seek care, and improve the quality of life of family caregivers of persons with MDs.
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana; kenneth.asayah@kintampo-hrc.org.
authors.forename: Kenneth Ayuurebobi
authors.initials: KA
authors.lastname: Ae-Ngibise
authors.affiliation: Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
authors.forename: Victor Christian Korley
authors.initials: VC
authors.lastname: Doku
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana.
authors.forename: Kwaku Poku
authors.initials: KP
authors.lastname: Asante
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana.
authors.forename: Seth
authors.initials: S
authors.lastname: Owusu-Agyei
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000191:economics / Q000523:psychology*; D005190:Family; D005260:Female; D005869:Ghana; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life; D012424:Rural Population; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology; D013997:Time Factors; D055815:Young Adult
keywords: Kintampo; burden; mental disorders; primary caregiver; stigma