Care burden and outcomes in young carers during and after the COVID‑19 pandemic: psychological distress and cognitive–emotional aspects

Global social and policy concerns regarding young carers' care burden are increasing, but the outcomes of their caring responsibilities, especially in Asian countries, remain inadequately explored. We empirically examined the associations of care burden with psychological distress and cognitive-emotional aspects using cross‑sectional online surveys of young carers aged 15-19 living throughout Japan in 2021 (during the COVID‑19 pandemic) and 2024 (post‑pandemic). Each survey sampled a different group of young carers. The Kessler Psychological Distress Scale and Positive and Negative Outcomes of Caring were used to assess outcomes, which were analyzed in relation to care complexity and intensity. The mean psychological distress score was 7.33, with significantly higher scores observed during the pandemic compared with 2024. However, both positive and negative scores on the cognitive and emotional outcomes instrument were significantly elevated post-pandemic. We observed a heavy care burden, associated with worsened psychological distress. Regarding cognitive-emotional aspects, greater care task complexity was associated with an increase in both negative and positive responses. Policies should offer tailored support for young carers, especially during emergencies, ensure that they receive mental health support, tackle issues associated with young carers' isolation, and deliver accessible and youth-friendly social resources.