When caring becomes too much, death can seem like the only way out
Dr Siobhan O’Dwyer Associate Professor of Social Care
| University of Birmingham
Forced to plug the gaps in a crumbling health and social care system, unpaid carers have reached their limit, and the government must act before it’s too late.
Martina Karos was an excellent mother. Her eight-year-old daughter, Eleni, was happy and thriving, despite a rare genetic condition that left her blind, epileptic, and unable to speak, walk, or swallow. But Martina’s devotion masked a deep despair. Caring 24/7 for years on end had left her exhausted, isolated, and overwhelmed, and she felt broken by the constant battle to secure support for Eleni. Although she’d thought about ending her own life, she knew her death would leave Eleni alone in a system that simply couldn’t be relied upon to provide high-quality care. And so, desperate to escape an impossible situation, but unwilling to leave her daughter behind, Martina killed Eleni and then herself in Salford on 23rd September 2024.*
Martina and Eleni’s story is not unique. Every month an unpaid carer kills the person for whom they were caring. Thousands more think about killing themselves. In fact, research has shown that as many as 40 per cent of unpaid carers have thought about suicide, with some of those also thinking about homicide (killing the person for whom they care). While it’s not clear how many carers have died by suicide, at least 1 in 10 of those thinking about suicide have already attempted to end their life.
Caring conveys unique risk factors for suicide that are not seen in the general population. In particular, carers who lack support, who are in conflict with professionals, or who feel trapped in the caring role, are more likely to think about suicide. These risk factors are also evident in carer-perpetrated homicides, particularly those cases where a devoted carer kills because they simply cannot keep caring.
Although most carers never tell anyone about their thoughts of suicide and homicide, those who do say the response is rarely helpful. A prescription for antidepressants or a referral to a support group does little to address the underlying problem: a lack of support for, and respite from, the caring role.
As awareness of suicide and homicide risk in unpaid carers has grown, there have been excellent local efforts to address the problem. In Leeds, Bristol, Herefordshire, Oxfordshire, and Salford, multi-agency groups are developing strategies to support at-risk carers. But local action is not enough. Carers need change on a national scale.
To prevent deaths, the British government must reduce its reliance on unpaid carers, via greater investment in disability benefits and high-quality healthcare, social care, education, and employment services for disabled people. The government must also signal its clear commitment to unpaid carers, through a national carers strategy and improved funding for carer support services.
A call for better support for unpaid carers, and those they care for, is not new. Carers, and the organisations who advocate for them, have long demanded better. But the emerging evidence on suicide and homicide gives the call for change renewed urgency. Around the anniversary of Martina and Eleni’s deaths, we want to act now and work together with this government to give unpaid carers the support they so desperately need.
If you’re a carer in need of urgent support, please contact Samaritans on 116 123.
*Shared with the permission of Martina’s family
Dr Siobhan O’Dwyer is Associate Professor of Social Care at the University of Birmingham and has spent the last 15 years studying the needs and experiences of unpaid carers, with a particular focus on suicide and homicide risk. She advocates for evidence-based change in pursuit of a fairer and more sustainable world.
References
- O’Dwyer, S.T. et al. (2021). Suicidality in family caregivers of people with long-term illnesses and disabilities: A scoping review. Comprehensive Psychiatry, 110, 152261. Available at https://shorturl.at/p3CUe
- O’Dwyer, S.T. et al. (2024). Suicidal thoughts and behaviors in parents caring for children with disabilities and long-term illnesses. Archives of Suicide Research, 29(2), 468-485. Available at https://shorturl.at/6trCj
- O’Dwyer, S.T. et al. (2025). From caring to killing: A typology of homicides and homicide-suicides perpetrated by caregivers. Social Sciences, 14(6), 376. Available at https://shorturl.at/lcvWv
