Evidence map›Paper›PMID 41899702›Full record

ArticleInternational journal of environmental research and public health2026

Multi-Stakeholder Perspectives on Barriers to Mental Health Support for Informal Caregivers.

Maria Lizette Rangel, Donaji Stelzig, Cassandra Martinez Enriquez, Hoda Badr

Abstract read
In one paragraph

Article in International journal of environmental research and public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Maria Lizette RangelDepartment of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.ORCID 0000-0003-3968-2267
Donaji StelzigTrust CHW Training Center, Houston, TX 77054, USA.
Cassandra Martinez EnriquezDepartment of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
Hoda BadrDepartment of Medical Oncology, Sidney Kimmel Comprehensive Cancer Center, Thomas Jefferson University, 834 Chestnut Ave Suite 314, Philadelphia, PA 19107, USA.

Funding

NHLBI Maternal Morbidity and Mortality (3M) Administrative Coordinating CenterOT2HL158287 · NHLBI · WESTAT, INC. · PI Chanza Baytop · 2020 to 2026
$433.8M
NIH Community Engagement Alliance (CEAL) OT2HL158287
6 · The paper itself

Abstract

backgroundInformal caregivers experience elevated psychological distress but face substantial challenges in accessing mental health support. Prior research has focused primarily on individual or interpersonal determinants, with less attention to how organizational, community, and policy contexts shape access and contribute to inequities in service availability.

methodsFifty-one stakeholders, including 17 informal caregivers, 23 community health workers (CHWs), and 11 mental health professionals, completed a demographic survey and 60-90-min semi-structured interviews in English or Spanish. Data were analyzed using thematic analysis, combining deductive coding guided by the Socioecological Model with inductive identification of emergent themes.

resultsParticipants identified both barriers and supports influencing access to caregiver mental health support across socioecological levels. Individual-level barriers included limited mental health literacy, stigma, competing responsibilities, and language or technology challenges. Interpersonal barriers reflected family minimization of distress and limited encouragement for help-seeking. Organizational barriers involved program instability, restrictive eligibility criteria, long wait times, limited cultural responsiveness, and workplace constraints, while community-level influences included stigma and scarce affordable services. Policy-level barriers reflected immigration-related exclusions and the absence of caregiver-specific mental health coverage. Identified supports, such as CHW navigation and culturally responsive services, were often constrained by structural and organizational limitations.

conclusionsCaregivers face intersecting, multilevel barriers that constrain access to mental health support, while available supports are frequently insufficient to overcome structural constraints. Findings highlight the need for coordinated public health and systems-level strategies that address organizational and policy conditions shaping equitable access to caregiver mental health care.

Indexed as

CaregiversHealth Services AccessibilityMental Health ServicesAdultCommunity Health WorkersFemaleHumansMaleMental HealthMiddle Agedcommunity health workershealth services accessinformal caregiversmental health supportqualitative researchThe Socioecological Model

Identifiers

PMID41899702
PMCPMC13026114

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.