Service providers’ perspectives on strategies to reduce caregiver burden among informal carers of people living with mental health conditions in rural South Africa: A qualitative descriptive study

PLOS Glob Public Health. 2026 May 20;6(5):e0006481. doi: 10.1371/journal.pgph.0006481. eCollection 2026.

ABSTRACT

Caregiver burden is a public health problem affecting the emotional, physical, and mental health of informal caregivers of persons with severe mental health conditions worldwide. When caregivers feel overwhelmed, their ability to provide quality care is compromised. Although global evidence highlights the need for interventions to alleviate caregiver burden, such evidence is limited in low-resource settings, particularly in sub-Saharan Africa. This study addressed this gap by exploring service providers’ perspectives on formal and informal mental health services aimed at alleviating caregiver burden in rural South Africa. Descriptive qualitative design was adopted, and seven semi-structured individual interviews and two focus groups were conducted with twenty-nine (n = 29) mental health service providers in the Bushbuckridge municipality. Reflexive thematic analysis was performed using NVivo 12 software. Two themes were identified: caregiver and health system support strategies, and community and structural support strategies. Participants highlighted the need for caregiver-oriented mental health services and proposed multilevel strategies, including caregiver empowerment, psychoeducation, support groups, family therapy, and psychosocial rehabilitation. They also emphasised community-based support, awareness, respite and recreational services, intersectoral collaboration, and the development of targeted policies and guidelines to strengthen support for informal caregivers. The findings reflect service providers’ practical understanding of caregivers’ complex challenges and a clear vision for actionable, context-appropriate strategies to strengthen caregiver support. Given the service providers’ frontline role in mental health care, these perspectives are essential for informing the planning and implementation of interventions that are realistic, acceptable, and sustainable in low-resource settings. Future research should focus on developing and testing these strategies to enhance support systems for informal caregivers and improve outcomes for both caregivers and people living with mental health condition.

PMID:42160382 | DOI:10.1371/journal.pgph.0006481