The Royal College of General Practitioners has recently recommended that a register of the UK’s 7 million carers be created and that a “carers’ champion” be present in each General Practice in light of evidence that up to 40% experienced depression or psychological problems.
As psychiatrists we understand the enormous impact of mental illness, not only on sufferers but also on family and friends who provide care, support and comfort during periods of ill health. Sufferers often become temporarily more dependent upon others as their functioning diminishes during acute illness episodes of depression, anxiety or psychosis. More significantly, we see the emotional and the material costs of chronic conditions such as schizophrenia or dementia for families whose untiring, unconditional sacrifice is thought to save the public purse an astonishing £119 billion per year.
If we are not mindful of the health of carers, we are not only increasing the risk to our own patients but guilty of taking for granted the indispensable skills of the legions of families and friends who assist us in facilitating recovery and keeping patients safe.
If we take dementia as an example, family members – often spouses – can find themselves on call 24 hours per day, 365 days per year. They are asked to manage a vast spectrum of challenges from repetitive conversations and the misplacing of objects to sleepless nights, agitation, wandering and even aggression. It is not difficult to imagine the impact of this chronic stress, compounded by the grief of observing gradual erosion of the personality of a loved one.
A national register of carers strikes me as an excellent idea ensuring recognition but also regular screening for the well-understood physical and psychological sequelae of chronic stress including depression and anxiety. As psychiatrists we should be alert to the health of our patients’ carers. In ensuring the health of the nation’s carers we are going a long way to maintaining the health and safety of our own patients.
The Guardian. 2013. Carers should be monitored for mental health problems, warn doctors. [online] Available at: http://m.guardian.co.uk/society/2013/may/11/carers-monitored-mental-health-problems [Accessed 11th May 2013].
BBC News. 2013. Screen carers for depression, say doctors’ leaders. [online] Available at: http://www.bbc.co.uk/news/health-22478706 [Accessed 11th May 2013].