To explore the social support and associated factors among family caregivers of persons with severe mental illness, providing a theoretical basis for the development of evidence-based strategies to enhance the level of social support in this group.

A cross-sectional design was used. Multistage sampling was used to select three tertiary grade A mental health organizations from three cities located in eastern, central, and western China, respectively (one was extracted from each city) , then from which, family caregivers of persons with severe mental illness who received outpatient services between August 2018 and December 2019 were selected, and their family caregivers (n=1 001) were recruited as participants. A self-administered survey was conducted in the family caregivers using a questionnaire〔consisting of two parts: demographics and the Social Support Rating Scale (SSRS) 〕compiled by our research team to collect their individual and family information and social support status, as well as patients' (the care receivers') information. Multiple linear regression was employed to identify associated factors for the total score and domain scores of SSRS.

The mean total score of SSRS for the family caregivers was (34.4±9.1) . And the mean score for its three domains, subjective social support, objective social support, and social support utilization was (20.3±6.2) , (7.5±2.8) , (6.6±2.3) , respectively. The type of occupation of the caregivers, and the type of mental diseases and stability of symptoms of patients cared by them, as well as mean household monthly income per person were associated with the total score of SSRS for the family caregivers (P<0.05) . Furthermore, marital status and religious belief of caregivers, as well as their relationship with the patients cared by them also affected the total score of SSRS of the family caregivers (P<0.05) . As for the scores of domains of SSRS, they were found to be influenced by the type of occupation of the caregivers, the type of mental diseases and stability of symptoms of patients cared by them, and mean household monthly income per person (P<0.05) . Besides that, gender, marital status, living area (rural or urban) , and religious belief of caregivers, their relationship with patients cared by them, and the amount of family subsidies also affected the score of subjective social support of family caregivers (P<0.05) ; the amount of family subsidies also affected the objective social support score of family caregivers (P<0.05) ; gender and living area (rural or urban) of caregivers, and the amount of family subsidies also affected the score of social support utilization of family caregivers (P<0.05) .

Family caregivers of patients with severe mental illness possessed a low level of social support, had limited access to social support, perceived insufficient support, and used social support rather insufficiently. There were differences in factors associated with their overall social support and domain-specific social support. More attention should be paid to family caregivers who are single, unemployed, have low household monthly income per person, care for patients with schizophrenia or unstable mental symptoms, and provide them with support in accordance with their needs, by which their care burden can be alleviated, and their physical and mental health will be improved eventually.

了解严重精神障碍患者家庭照护者的社会支持现状，分析影响其社会支持水平的因素，旨在为针对性干预策略的制定奠定基础。

采用多阶段抽样方法，抽取我国东、中、西部各1座城市中的1家三级甲等精神卫生机构作为调查机构，选取2018年8月至2019年12月在上述3家三级甲等精神卫生机构门诊就诊的严重精神障碍患者的家庭主要照护者1 001例作为调查对象，采用自设问卷〔一般资料调查表、社会支持评定量表（SSRS）〕对家庭照护者进行调查，收集家庭照护者的个人、家庭信息及照护对象资料，并评估家庭照护者的社会支持情况。采用多重线性回归分析影响严重精神障碍患者家庭照护者社会支持总体水平及各维度水平的因素。

1 001例严重精神障碍患者家庭照护者社会支持总分为（34.4±9.1）分，主观社会支持、客观社会支持及社会支持利用度得分分别为（20.3±6.2）、（7.5±2.8）、（6.6±2.3）分。照护者的职业类别，照护对象所患精神疾病种类、精神症状稳定程度，以及家庭人均月收入是影响严重精神障碍患者家庭照护者社会支持总体水平及各维度水平的因素（P<0.05）。除上述共性因素外，照护者的婚姻状况、宗教信仰，照护者与患者的关系可影响严重精神障碍患者家庭照护者社会支持总体水平（P<0.05）；照护者的性别、婚姻状况、居住地、宗教信仰，照护者与患者的关系，家庭获补助数量可影响严重精神障碍患者家庭照护者主观社会支持水平（P<0.05）；家庭获补助数量可影响严重精神障碍患者家庭照护者客观社会支持水平（P<0.05）；照护者的性别、居住地，家庭获补助数量可影响严重精神障碍患者家庭照护者社会支持利用水平（P<0.05）。

严重精神障碍患者家庭照护者社会支持水平整体较低，社会支持来源较少，感知到的社会支持强度较低，对社会支持的利用意愿较弱，且影响严重精神障碍患者家庭照护者社会支持总体水平及各维度水平的因素不尽相同。未来，应重点关注无配偶、未就业、家庭月收入较低、精神分裂症患者和精神症状不稳定患者的家庭照护者，在了解其需求的基础上提供相应的支持和帮助，以缓解其照护负担，进而提高其身心健康水平。