Mental/Behavioral Health

Why COVID-19’s toll on unpaid caregivers’ mental health is ‘terrible and heartening’

New research reveals significant prevalence of suicidal ideation, depression, anxiety and stress among unpaid caregivers. But there are opportunities within the challenges.

Tom Sullivan | June 30, 2021

More than 1 in 10 U.S. adults are unpaid caregivers walking around with active suicidal ideation. What’s more, 32 percent experience active suicidal thoughts while 39 percent experience passive suicidal thoughts.  

While that sinks in, consider: Among 10,444 U.S. adult respondents to the same CDC survey that uncovered the aforementioned statistics about suicide, 70 percent of parents and/or caregivers reported adverse mental health symptoms, 55 percent reported anxiety or depression, 54 percent said COVID-19 induced stress and trauma and 32 percent experienced passive suicidal thoughts.  

“The results are terrible and heartening at the same time,” says Alexandra Drane, CEO and co-founder of ARCHANGELS and one of the study’s authors.  “This is heartening because anyone who has been an unpaid caregiver understands this reality, but they think they’re alone. Knowing that other people feel the same way in and of itself is care that is going to help people feel better.”  

That stark reality also creates an opportunity for executives to lead their organizations in addressing the problem by normalizing it, reframing how caregivers are seen and supporting them appropriately — in many cases with existing resources from previous investments.  

The societal perception of a typical unpaid caregiver is a middle-aged woman caring for a parent while simultaneously raising young children of her own. Many caregivers simply identify as a mother, father, son or daughter fulfilling those duties when, in actuality, they are delivering care despite not being a doctor, nurse or clinician. The CDC research, in fact, found that 54 percent of caregivers are men.    

While 50 percent of survey respondents do not know what the term caregiver means, what has become clear are the factors driving adverse mental health scenarios among the population.   

If we want to build sustainable, scalable programs and bend the trend to keep our economy sustainable and help humans feel okay, we have to reach and support caregivers.

Alexandra Drane, ARCHANGELS

The ARCHANGELS Caregiver Intensity Index, in fact, assessed the drivers of adverse mental health symptoms to determine that family disagreements or resentment about caregiving responsibilities each increase the odds of leading to adverse mental health symptoms by a factor of three. The same assessment also found that feeling underprepared as a caregiver, not having as much personal freedom as desired, and having had to cut down on expenses due to caregiving all increase the odds of adverse mental health symptoms by a factor of two.  

“Those factors drive intensity but they can also alleviate intensity by enabling people to understand they need help with the things that are harder and do more of the things that are better,” Drane says.  

According to the CDC: “Caregivers of adults with mental health or substance use conditions, adults currently ill with COVID-19, or adults at risk for severe COVID-19 reported more adverse mental health symptoms than did caregivers of adults with other conditions, highlighting the need for education and support for caregivers in these roles.”  

David Michel, CEO, Catapult Health, a digital health company focused on employer wellness, says executives can offer institutional infrastructure, such as a connection to behavioral health services, that more closely equates to common physical health benefits.  

“Don’t think of psychological benefits as an afterthought. Bring it on par with the care you give to a chronic condition management program for diabetes, hypertension, heart disease, or as a weight loss program. It is in those same categories, and they’re all interconnected, yet it tends to be one that we don’t spend much time or resources on,” Michel says in the Health Evolution article Data dive: Employers are missing the mark with mental health in the workplace 

Many health plans, health systems and employers already offer mental health services, Employee Assistance Programs, while organizations instituting caregiver programs are becoming more common. An obstacle, however, is that many programs are underutilized because people do not know they exist, Drane says.  

“If you look at what’s impacting our productivity and the psychological health challenges that people are having, it’s a huge challenge for companies,” Michel says.     

Drane adds that health executives of all types should be talking about the problem and supporting it with a combination of data and stories that illustrate what can be accomplished because the only factor that lowers the odds of experiencing adverse mental health is if people have support. The ARCHANGELS 2019-2021 Caregiver Intensity Research also found that if caregivers know that even one person exists to support them, they experience a 40 percent lower risk of depression, a 30 percent lower risk of anxiety and, even if they do not use the resources, a 70 percent lower risk of stress.  

“Caregiving is the epicenter of all of it. If you are a caregiver, you are going to have financial stress, relationship stress, workplace stress,” Drane says. “If we want to build sustainable, scalable programs and bend the trend to keep our economy sustainable and help humans feel okay, we have to reach and support caregivers.” 

About the Author

Tom Sullivan, EVP & Editor-in-Chief of Digital Content

Tom Sullivan brings more than two decades in editing and journalism experience to Health Evolution. Sullivan most recently served as Editor-in-Chief at HIMSS, leading Healthcare IT News, Health Finance, MobiHealthNews. Prior to HIMSS Media, Sullivan was News Editor of IDG’s InfoWorld, directing a dozen reporters’ coverage for the weekly print publication and daily website. Contact: or @SullyHIT on Twitter.