A cross-sectional quantitative design was used in this study, in which 160 FCs from three ethnic groups (48 Caucasian, 61 Chinese, and 51 Vietnamese) participated. They completed a survey with standardized measures of variables: burden, measured by the Caregiver Burden Scale; mental health, measured by the 5 items for mental health from the 36-item Short Form Medical Outcome Survey; self-care practice, measured by the Health Promotion Lifestyle Profile; social support, measured by the Perceived Social Support Scale; stigma, measured by the Affiliate Stigma Scale; and structural barriers, measured by the Help-seeking Barriers Scale.

Analysis of variance revealed significant group differences in self-care practice (F[2, 157] = 4.56, p < 0.01) and affiliate stigma (F[2, 157] = 3.12, p < 0.05) as Caucasian FCs showed higher self-care and lower stigma than both Chinese and Vietnamese. There were no group differences in other variables, including burden and mental health outcome (RQ1). Hierarchical multiple regression analysis showed that a lower burden (standardized β = -0.21, p < 0.01), more social support (standardized β = 0.17, p < 0.01), and self-care practices (standardized β = 0.25, p < 0.01) predict better mental health, after controlling for caregivers’ age, ethnicity, and educational levels. The results also showed a partial mediation role of self-care and social support in mental health (RQ2).

This study found that caregiving burden has significant, adverse impacts on FCs’ mental health and that self-care and social support play mediating roles in this relationship. These findings suggest that social workers need to take initiatives to develop intervention programs to enhance self-care practices and social support for FCs when working with PMI. For caregivers to provide the best care for their loved ones with mental illness, more services and supports for caregivers should be incorporated into policy and funding.