Psychosocial Interventions for Caregivers of People Living with Schizophrenia in Low- and Middle-Income Countries: A Scoping Review Protocol

This research is a scoping review of psychosocial interventions for caregivers of people living with schizophrenia in low and middle income countries (LMICs). In many LMICs, treatment gaps for severe mental illness exceed 80%, and families provide most day to day care with very limited support. Caregivers frequently experience high levels of psychological, social, physical and financial burden, including elevated rates of depression and anxiety. Although there is a strong global evidence base for family and psychosocial interventions in schizophrenia, existing reviews focus mainly on patient outcomes and high income settings, and do not systematically map interventions that have been developed, culturally adapted or evaluated specifically for caregivers in LMICs. This scoping review aims to map the scope, characteristics and reported outcomes of psychosocial interventions for caregivers of people living with schizophrenia in LMICs. The review will identify which types of interventions have been implemented, how they have been culturally adapted and delivered, what caregiver specific outcomes (such as burden, depression, anxiety, quality of life and expressed emotion) have been assessed, and what is known about feasibility, acceptability and implementation barriers and facilitators. A particular focus is on evidence from sub Saharan Africa and on gaps relevant to West African contexts, where very few caregiver focused interventions have been described to date. The review will follow the methodological framework of Arksey and O’Malley and Levac and colleagues, alongside updated guidance from the Joanna Briggs Institute and the PRISMA ScR reporting checklist. Systematic searches will be conducted in MEDLINE, EMBASE, PsycINFO, Global Health and the Cochrane Database of Systematic Reviews, complemented by searches of WHO and other grey literature repositories. Two reviewers will independently screen studies against predefined inclusion criteria and chart data using a structured extraction form. Findings will be synthesised narratively and thematically and presented with descriptive numerical summaries and an evidence gap map. No primary data collection is involved, so ethical approval is not required. The expected outputs are: (1) an open access scoping review manuscript, including full search strategies and a PRISMA ScR flow diagram; and (2) a structured map of existing caregiver focused psychosocial interventions in LMICs, highlighting which approaches and outcome domains are most and least studied. These outputs will inform the selection and cultural adaptation of a feasible, acceptable psychosocial intervention for caregivers of people living with schizophrenia in The Gambia.