Family burden of schizophrenic patients and the welfare system; the case of Cyprus
Background: The shift from asylum to community care for mental health patients has burdened the providers of primary health care and, more than all, families. As a result, numerous studies [Soc Psychiatry Psychiatr Epidemiol 31:345–348, 1995, J Health Socisl Behav 36:138–150, 1995] have focused on the burden of care experienced by family members living with individuals with severe mental disorders. This kind of provision, also extols a significant cost to the society at large in terms of significant direct and indirect costs. A cost that may be even higher in times of severe socio-economic crisis. Methodology: This study, firstly, aims to examine the burden that the family members experience by caring for individuals with schizophrenia and the identification of the parameters, in a micro and macro level, that affect family burden. Secondly, this study aims to investigate whether the welfare state will be fit to help vulnerable groups as the one studied, especially during economic crisis periods when austerity measures are being implemented into welfare systems. For data collection purposes this study employed the Involvement Evaluation Questionnaire [Schizophr Bull 1998, 24(4):609–618]. The sample consisted of caregivers either living in rural or urban areas of the district of Nicosia, the capital of the Republic of Cyprus. These people were attending regular meetings with their allocated Community Psychiatric Nurses (CPN) in Community Mental Health Centres (CMHC). Results: Analysis of covariance (ANCOVA) was applied with the tension, the supervision, the worry, and the encouragement entering as dependent factors. In each case, participant’s age, gender, marital status, income, number of people living in the same house with the participant, degree of relationship between the caregiver and the person suffering from severe mental disorder, the age of the relative, and the gender of the relative, were entered as independent factors. Four ANCOVAs were performed, one for each dimension of the family burden. The results from this analysis produced only one significant main effect of the gender of the relative on supervision [F(1,118) = 4.40, p = .011, etap2 = .053] with male relatives suffering from schizophrenia requiring higher supervision than female ones as their relative caregivers responses indicate. Conclusions: Consequently, families under great stress due to the reasons derived from the weaknesses of the welfare system described throughout this paper would give up and reject the mentally ill individuals who would become outcasts socially. Therefore, health systems need to aim to the development of psychosocial provisions for both family caregivers and patients as to decrease the family burden rates and increase the possibility of smooth transition to the society.