A person admitted to the Intensive Care Unit (ICU) will, in general, experience a long and complex process of recovery, which can span months or even years.

Recovery can involve physical, cognitive and emotional healing, with one in three ICU survivors still experiencing physical or mental effects 12 months after leaving the ICU.

But what about the family members that are intimately involved in supporting the patient’s recovery.  What’s the impact to them?

In a first of its kind study based on an Australian population, Dr Sumeet Rai, from the Australian National University (ANU) School of Medicine and Psychology, has looked at how the relationship dynamic between a patient and their family member can influence the psychological health of the other.

“Often, family members become involuntary caregivers, and this can have an impact on their health. Over time, a co-dependent relationship may unintentionally develop between the ICU survivor and their caregiver,” Dr Rai said.

“Through self-report we found that over a third of carers (35% at 12 months) had post-traumatic stress disorder symptoms after their loved one had left the ICU, and when asked about their quality of life a third of carers (32% at 12 months) showed symptoms in the depression and anxiety domains.”

“We also know from the self-reporting that many carers experience pain and discomfort in their bodies, so we know that their quality of life is impacted emotionally and physically.”

“Where the results get really interesting is in looking at the ICU survivors’ reporting on issues such as pain and discomfort and comparing it to reporting by the family member.”

“There is a strong emotional connection between ICU survivors and their family member. For example, if an ICU survivor reported feeling depressed at 12 months after discharge, their family members were nearly 14 times more likely to report similar symptoms,” Dr Rai advised.

The findings point to the need to consider mental health support services, as part of the rehabilitation process, for the patient and their carer.

“The medical system is good at connecting patients with supports for physical recovery, such as physiotherapy or speech therapy. However, access to mental health support is generally only referred if the patient has obvious mental health needs while in the hospital.”

“Importantly, the ICU patient group didn't have any pre-existing psychological issues, so they would not have been referred to mental health services while in hospital.”

“Ideally, as part of an early intervention approach, staff providing support to ICU survivors and their carers during the recovery journey, could institute processes to educate and screen patients and carers for mental health issues –  because there is a significant gap, particularly for the carer.”

Dr Rai added, “In the Canberra Hospital ICU, where I work, we advise family members early in the recovery process that looking after their own mental health is important and provide them information about where they could go for mental health support.”

"Check-ins around mental health should not end once the patient has left hospital. Research shows that carers want to talk about their experiences and want to be heard and often will need psychological support throughout their family members recovery process."

Dr Sumeet Rai was recognised with an Outstanding New Researcher Award at the 2025 CHARM Rising Star Awards for his emerging leadership in critical care research. 

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