Objectives: More than 80% of all long-term care services globally are provided by informal caregivers. However, they are often overlooked, underrecognized and insufficiently supported. This study analyses how providing informal care affects mental health and how the negative effects may be prevented or mitigated.

Methods: A cross-sectional study was conducted among informal caregivers in Serbia. Compassion fatigue and compassion satisfaction (CS) were measured with the Professional Quality of Life Scale (ProQOL) version 5. Compassion fatigue is a concept from the formal care setting, a known work-related phenomenon linked to secondary trauma from prolonged work with suffering/ traumatized patients. ProQOL subscales demonstrated good reliability with a Cronbach alpha coefficient of 0.917 on the CS subscale, 0.891 on the burnout (BO) and 0.857 on the Secondary Traumatic Stress (STS) subscale.

Results: A total of 187 informal caregivers participated, with an average age 56.95 ± 12.86 years. 74.9% of the participants were female; the majority married or partnered (62.6%). The median time spent in caregiving was 4 years, ranging from several months to 50 years. The majority of the sample had a moderate compassion satisfaction (72.2%) with moderate levels of compassion fatigue, represented by the BO (67.4%) and STS (64.2%) subscales. Very few participants scored high on CS (3.7%) and high on STS (5.3%). Sex based differences were found for CS and BO domains, with both CS and BO being higher among women (p = 0.002 and p = 0.026, respectively). BO was found to be higher among singles (p = 0.049). Differences were found regarding urban/rural community, with CS being higher among informal caregivers in urban community (p = 0.041) and STS being higher in rural community (p = 0.004). There was no correlation between age and years spent in caregiving and ProQoL domains.

Conclusions: Over the coming decades, in the absence of a proactive approach, the increasing needs for care will significantly increase the burden of informal caregivers and intensify its consequence on mental health, by pushing moderate levels of burnout and STS towards higher values.