Impact of COVID-19 outbreak on mental health and perceived strain among caregivers tending children with special needs

•The COVID-19 outbreak has had a significant impact on caregiver strain compared to perceived strain before the pandemic.•Prevalence of depressive symptoms is high among caregivers of children with special needs.•Negative perception of homecare therapy is associated with higher perceived strain and poor mental health.•Not using tele-rehabilitation and perception of it being a poor medium for rehabilitation pose greater mental health risks. While COVID-19 outbreak has had adverse psychological effects in children with special needs, the mental state and burden on their caregivers during this pandemic has yet to be reported. The objectives of this study were to describe the mental health status and the change in perceived strain among caregivers during the COVID-19 outbreak. Two hundred sixty four caregivers completed an online survey that assessed demographics, use and perspective on tele-rehabilitation, homecare therapy, caregiver’s strain and mental health. The prevalence of depression, anxiety and stress symptoms were found to be 62.5 %, 20.5 % and 36.4 % respectively. A significant difference in caregiver strain (p