ORIGINAL ARTICLE Trapped like a butterfly in a spider’s web: Experiences of female spousal caregivers in the care of husbands with severe mental illness Farnaz Rahmani MSc, PhD Candidate 1 | Hossein Ebrahimi PhD, Professor 2 | Naeimeh Seyedfatemi PhD, Professor 3 | Hossein Namdar Areshtanab PhD, Assistant Professor 2 | Fatemeh Ranjbar MD, Professor 1 | Bill Whitehead PhD, Assistant Professor 4 1 Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran 2 Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran 3 Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran 4 University of Derby, Derby, UK Correspondence Hossein Ebrahimi, Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran. Email: ebrahimih@tbzmed.ac.ir Funding information The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was supported by grant from the deputy of research of Tabriz University of Medical Sciences (5825). Aims and objectives: To explore the experiences of female spousal caregivers in the care of husbands with severe mental illness. Background: Family involvement in the care of patients with chronic illness is essential to provide a backbone of support for them. However, little is known about how female spousal caregivers are confronted with challenges while taking care of their husbands with severe mental illness. Design: An exploratory qualitative study. Methods: Fourteen female spousal caregivers of people with severe mental illness (defined here as schizophrenia, schizoaffective disorders and bipolar affective disor- ders) were recruited using purposive sampling and were interviewed using a semistructured in-depth interview method. Data were analysed by conventional content analysis until data saturation was achieved. Results: Care of a husband with severe mental illness had a disruptive influence on the emotional relationships of the family and resulted in emotional detachment over time. Despite the caregivers’ struggle to protect their families, the lack of supportive resources caused emotional exhaustion. Caregiving tasks interfering with their many other responsibilities, along with being a reference for family matters, led to loss of self. Consequently, they experienced psychological distress because of the transition to a caregiver role without any supportive resources. Conclusion: Constant caring, without supportive resources, forced them to do vari- ous roles and manage other issues within the family. Being unprepared for a care- giving role led to the psychological distress of female spousal caregivers. Therefore, adequate information, education and supportive resources must be provided for spouses to facilitate their transition to caregiving roles. Relevance to clinical practice: It is necessary to pay close attention to the spousal caregivers’ own mental health problems while they care for their mentally ill hus- bands. Mental health professionals should adopt a new approach to the prioritisa- tion and planning of policies that support both family caregivers and patients. KEYWORDS caring, content analysis, family caregiver, mental disorder, qualitative study, spousal caregiver Accepted: 21 January 2018 DOI: 10.1111/jocn.14286 J Clin Nurs. 2018;27:1507–1518. wileyonlinelibrary.com/journal/jocn © 2018 John Wiley & Sons Ltd | 1507