The Role of Siblings in Caring for Middle-Aged and Older People With Severe Mental Illness: A Scoping Review.

The intersection of severe mental illness (SMI) and ageing poses significant health and psychosocial challenges for middle-aged and older adults with SMI. Informal care from siblings can be crucial for this group, who are less likely to have the involvement of spouses or children in their ageing. Despite growing interest in sibling support within mental health research, there is a lack of comprehensive understanding regarding siblings' roles in caring for their ageing relatives with SMI. We conducted a scoping review following Arksey and O'Malley's approach and reported results using the PRISMA-ScR guidelines. Identifying 28 English-language studies published between 2000 and 2024 from PubMed, Scopus, PsycINFO, Ovid MEDLINE and ProQuest, we synthesised key themes concerning the involvement of siblings in caring for individuals with SMI. The findings reveal a widespread willingness among siblings to provide care, though they often adopt a cautious approach. Many siblings feel unprepared to assume parental roles in long-term care, showing reluctance to engage in regular, intensive daily care activities. The extent of their involvement, its impact and their coping strategies are intricately linked to (1) the triangular relationship among parents and siblings with and without SMI, (2) socio-economic status and emotional and educational resources and (3) socio-cultural values. This review contributes to the development of scholarship by identifying critical directions for future research, practice and policy.