Impact of COVID-19 outbreak on mental health and perceived strain among caregivers tending children with special needs.
Sapna Dhiman, Pradeep Kumar Sahu, William R Reed and 3 others
PMID 33091712WHAT IT FOUND
Caregivers of children with special needs in India reported high rates of depression and significantly increased strain during the COVID-19 lockdown.
Factors like lack of tele-rehabilitation and difficulty with homecare therapy were linked to worse mental health, suggesting a need for better remote support and caregiver training.
Key findings
0162.5% of caregivers reported depressive symptoms, and perceived strain significantly increased from a mean of 4.30 before the outbreak to 7.29 during the outbreak.
02Caregivers who did not continue tele-rehabilitation or had a negative perception of it showed higher levels of depression, anxiety and stress.
03Children's dependency in eating, dressing and hygiene, along with the caregiver's perception of homecare therapy as difficult, was associated with higher caregiver strain and poor mental health.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study used self-reported data, which may be subject to recall bias, especially for the pre-lockdown strain scores. Participants were limited to those with English comprehension and internet access, primarily from major cities, which reduces generalizability to rural or lower-education populations. The cross-sectional design cannot establish causality between the lockdown and mental health outcomes. The severity of the child's disability and the caregiver's prior mental health history were not controlled for. The sample was highly educated (all had at least a bachelor's degree), which may not reflect the broader population of caregivers.
Declared interests
The authors declared no competing interests. The research did not receive specific funding from public, commercial, or not-for-profit agencies.
The easy way to misread this
Do not interpret the association between tele-rehabilitation and better mental health as proof that tele-rehabilitation itself reduces strain. The study is cross-sectional and self-reported, so it may be that caregivers who are already coping better are more likely to engage with and trust remote services. Additionally, the sample was highly educated and urban, so these findings may not apply to caregivers in rural areas or with lower literacy.