Is providing informal care risky? A mental health perspective in a Belgian population-based sample

Abstract Background Informal caregiving refers to providing unpaid assistance to a relative or friend who has a disease or a disability. The assumption that providing informal care leads to deleterious health outcomes is widespread and commonly accepted. However, several comments have been made about the need to question this belief. Methods To put this assumption to test, the Belgian National Health Survey from 2013 was used. In this nationwide sample, the association between informal care and mental health was investigated through the GHQ-12 and the SCL (depression, anxiety, and sleep subscales). Three complementary comparison were performed: (1) between informal caregivers and non-caregivers; (2) between informal caregivers at home, outside of home, and non-caregivers; (3) between informal caregivers providing care for more than 20 hours a week, those providing between 1 and 20 hours a week, and non-caregivers. Statistically significant differences were controlled afterwards for gender, age, and perceived quality of social support. Results Overall, the results show that, with a population-based point of view, informal caregivers are not particularly at risk. Few comparisons were statically different, and when they were, the effect sizes remained low. Conclusions Far from settling this debate, these results rather suggest that the key point might lie elsewhere, as informal caregivers represents a diverse population in itself. Therefore, the focus should probably not be on the sole investigation of the differences between informal caregivers and the general population, but rather on how and why some caregivers differ from other caregivers and how such difference can represent a risk for them. Key messages Informal caregiving is often seen as a risk factor for mental health, but our results point to non-significant and little differences. By questioning this assumption, we call for a better understanding of what could be at risk in informal care.