Integrative model of caregiving: how macro and micro factors affect caregivers of adults with severe and persistent mental illness.

The study tested an integrative model of caregiving by examining the effects of sociocultural characteristics, interpersonal relations, mental health service structure, consumers' symptoms, objective burden, and evaluation of service systems on the subjective experiences of caregivers. The sample consisted of 428 caregivers of adults with severe and persistent mental illness. Results from multiple regression analyses indicated that ethnicity was the most significant sociocultural factor on caregivers' worry, personal growth, and benefits. Caregivers enrolled in managed care plans worried more about their consumers' welfare and felt less gratified by their experiences than their counterparts from fee-for-service plans. Implications to and partnerships among caregivers and mental health service systems were discussed.