Associations among caregiving burden, social support, hope, mastery, and depressive symptoms in family caregivers of children and young people with mental illness: a chain mediation analysis

Caregiving burden and depressive symptoms are common among family caregivers of children and young people (CYP) with mental illness, but the interplay among psychosocial and coping resources are not well understood. This cross-sectional study aimed to assess the relationship between caregiving burden and depressive symptoms and the roles of social support, hope, and mastery in this relationship among Chinese family caregivers of CYP with mental illness. Totally 333 Chinese family caregivers of CYP with mental illness were recruited, who completed the 12-item Zarit Burden Interview, the 9-item Patient Health Questionnaire, Oslo 3-item Social Support Scale, the Herth Hope Index, and the Pearlin Mastery Scale between September 2024 and February 2025. Descriptive analysis, correlation analysis, and the PROCESS Macro model 6 in regression analysis were applied. Results showed that 63.7% of participants reported caregiving burden and 48.0% reported moderate to severe depressive symptoms. Moreover, caregiving burden ( r = 0.652, p < 0.001), social support ( r = -0.392, p < 0.001), mastery ( r = -0.500, p < 0.001), and hope ( r = -0.507, p < 0.001) were related to depressive symptoms. Importantly, social support, hope, and mastery formed multiple indirect pathways between caregiving burden and depressive symptoms. Mental healthcare workers should be aware that majority of family caregivers experience caregiving burden and depressive symptoms, and that programs enhancing family caregivers’ social support, hope, and mastery should be considered to support these family caregivers.