Liang honored for research highlighting mental health of family caregivers

When Jiaming Liang, PhD, found out he had won an award for one of his publications, nobody was more surprised than Liang.

An assistant professor at UTHealth Houston School of Public Health in San Antonio, Liang has been awarded the Regional Award (North America) for Excellence in Publication in Behavioral Medicine by the International Journal of Behavioral Medicine. His work, published in 2023, was recognized for its outstanding contribution to the field and will be formally honored at the upcoming 2025 International Congress of Behavioral Medicine in Vienna, Austria.

Liang’s research examined how the stresses of caregiving that are caused by both measurable tasks, such as doctor appointments and physical care, as well as the perceived emotional burden of caregiving affect the mental health of family caregivers over time. Using national datasets and a two-year longitudinal model, his study explored a critical but often overlooked issue: how caregiving contributes to depression and loneliness in caregivers.

“We looked at both the objective caregiving stress, such as tasks, and the subjective stress, or how burdensome caregivers feel their role is,” Liang explained. “We found it’s not just how much you do, but how you feel about it that impacts caregivers’ mental health.”

His research revealed that caregivers who spent more hours assisting loved ones with intensive needs, such as dementia, were more likely to experience social withdrawal, increased loneliness, and depressive symptoms. One of the study’s most novel contributions was its separation of objective and subjective stress, and how each independently influenced caregivers’ social well-being and mental health.

For Liang these findings are personal and informed by his own experiences of helping to care for his grandmother who had dementia when he was just a teenager growing up in China.

“We just thought it was part of normal aging, and no one really considered getting my grandma diagnosed or treated at the time,” Liang said.

After witnessing his grandmother’s suffering and eventual death, he became dedicated to studying and understanding how to improve caregiving systems and policies.

In his paper and ongoing projects, Liang is also examining cultural differences in caregiving. He’s found that African American families often have larger caregiving networks and may be more emotionally collaborative. Non-Hispanic, white caregivers were more likely to rely on paid services and experienced more rapid increases in social isolation, particularly when navigating complex family dynamics.

“But across all groups, we’re seeing caregivers struggling, especially those going it alone,” he said.

Liang is now conducting interviews with caregivers in San Antonio, working with UT Health San Antonio physicians in geriatrics, family medicine, and psychiatry. He’s hoping to build a local research team and encourages students at the School of Public Health who are interested in caregiving, aging, or mental health to reach out.

Looking forward, he plans to study how caregivers help coordinate medical care for aging loved ones, navigating complex diagnoses, medications, and health systems.

“When someone has dementia and starts a new medication, they may just stop taking it if they don’t like how it feels,” Liang said. “And it’s the caregiver who has to figure that out and manage the fallout. That’s a huge burden.”

Liang sees the award as not just a personal recognition, but as an opportunity to raise awareness about the critical, growing challenges caregivers face, especially as the U.S. population ages and more families take on unpaid care responsibilities.

“This award helps me to know I’m on the right track, that this is an important topic for others,” Liang said. “Caregiving is a really huge issue for this country. For a lot of people their healthcare or insurance doesn’t cover a paid caregiver and so a lot of them are doing it totally out of pocket. It’s a financial and emotional burden and even for paid caregiving we don't have the workforce to meet the need. We need more support, not just from families, but from government programs and policies, too. Family caregivers are the hidden victims in our health care system. If we want to build a healthier society, we have to take better care of them.”