Mental health trajectories of men and women who start providing personal care: European findings from SHARE using propensity score matching.

Objectives: We examine the mental health trajectories of people who start providing personal care and compare their trajectories with matched controls who remain non-carers. We also investigate whether trajectories vary by gender, financial resources, and supportive long-term care policies.

Methods: Using nine waves of the Survey of Health, Ageing and Retirement in Europe, collected in 28 European countries from 2004 to 2022, we analyse longitudinal data from 68,075 men and women aged 50 or older. We identify transitions into regular personal care within the household and use depressive symptoms from up to four waves before and after transitioning into care to measure mental health trajectories. Financial resources are measured by household wealth, while three macro indicators assess (1) support for caregivers, (2) support for care recipients, and (3) public care service availability. Propensity score matching, applied separately for men and women, identifies matched non-caregivers from the same country, and we use piecewise growth curve models to examine changes before, during, and after becoming a carer.

Results: Both men and women have a clear increase in depressive symptoms when becoming a regular carer, and this increase even begins before the transition. The increase during the transition is slightly more pronounced for women and those with lower wealth, but we find no systematic differences by policy indicators.

Discussion: Our study highlights the need for improved support for carers. While national policies may influence the likelihood of becoming a carer, their effectiveness in mitigating the mental health impact of caring remains unclear.