Carers who save the public purse "billions" every year must be supported with a new government strategy, according to MLAs.
An estimated 220,000 people in Northern Ireland currently provide care to sick or disabled family members or friends.
After the last carers strategy was published in 2006, a cross-party group of MLAs has now called on the Department of Health's top civil servant to take action.
The joint letter to Peter May was signed by Sinn Féin's Jemma Dolan, the former DUP First Minister Paul Givan, Alliance's Paula Bradshaw, Ulster Unionist Alan Chambers and the SDLP's Colin McGrath.
Was happy to sign this on behalf of the SDLP. We must do all we can for carers - the unsung heroes in our health service to work day and daily to support loved ones at home and in the community. We need a strategy to implement much more support @SDLPlive https://t.co/30qMAEFgKn
— Colin McGrath (@ColinSDLP) April 17, 2023
They said the current strategy no longer reflected the "lives, challenges or priorities" for carers who sacrifice their income and career opportunities to keep the health and social care system from "certain collapse".
"They make an immense contribution to society, but in too many cases, what they get in return is a life defined by ill-health, extreme pressure, hardship and lost opportunities," the letter read.
Citing research from Carers NI, the MLAs said unpaid carers were being pushed to "breaking point by unrelenting caring duties, inadequate support from HSC services and severely limited chances for a break".
This resulted in one in four local carers describing their mental health as bad or very bad, with one in five saying the same about their physical health.
"This has knock-on effects on their ability to go to work – making it even harder to survive the cost of living crisis – enjoy a decent quality of life, and so much more," the MLAs stated.
The department has now been urged to lead a new policy direction with cross-departmental scope, addressing challenges in health and social care, welfare, housing, employment and beyond.
Without a Stormont Executive in place, they said the commissioning of a new 10-year cancer strategy set a precedent for such actions.
The MLAs said that "critical policy development work" could begin immediately, allowing it to be enacted immediately if Stormont returns.
While carers are routinely told how important they are, the MLAs said in reality they were "consistently finding themselves at the back of the queue" when policy and funding decisions were made.
Craig Harrison, Policy and Public Affairs Manager for Carers NI, said: “Our unpaid carers are saving the health system from collapse every day – being pushed to breaking point by unrelenting caring duties, inadequate support from statutory services and severely limited chances for a break.
"That takes its toll on their wellbeing and quality of life, and they’re crying out for a new government strategy to deliver the help and support they need."
He added: "We can’t afford to wait any longer to begin designing a new strategy for local carers, and the Department of Health has the power to begin this critical work immediately.
"That would send a welcome message to carers that addressing the challenges they face every day is being treated as a priority.”
