Exploring caregiver burden and coping responses in severe mental illness in rural India.

Caregiver burden among families supporting individuals with severe mental illness (SMI) in rural India remains inadequately explored despite its critical influence on treatment adherence and family well-being. Severe mental illness imposes substantial psychological, social and economic strain on caregivers living in resource-limited rural settings. Therefore, it is of interest to explore the lived experiences, perceived burden and coping responses among primary caregivers of individuals with SMI in rural India. A qualitative descriptive design was adopted and in-depth interviews were conducted with caregivers recruited from three rural primary health-care catchment areas. Thematic analysis revealed multidimensional caregiver burden characterized by emotional exhaustion, financial hardship, disrupted family routines, social isolation and stigma. Coping responses ranged from problem-focused strategies such as information-seeking and structured caregiving routines to emotion-focused and faith-based practices. Participants consistently reported unmet needs for psychoeducation, accessible mental-health services and respite support. Thus, we show the necessity of integrating caregiver-centred interventions, community-based psychoeducation and strengthened rural mental-health outreach services to reduce caregiver burden and improve continuity of care for individuals with SMI.