The aim of the study was to describe psychiatric caregivers’ perceptions of self-esteem and activities for patients with long-term mental illness. The study design used a qualitative approach, based on an open lifeworld perspective. A total of 13 caregivers at four psychiatric hospital units in a large Swedish city were interviewed about their views on patients’ physical activity and/or other pastimes, as well as their self-esteem and its bearing on the patients’ well-being. According to the caregivers, it is up to the patients themselves to decide what they wish to occupy themselves with. In the same time the caregivers’ opinions are that patients have difficulties to occupy themselves.The caregivers believe that patients’ disability is based in a lack of self-esteem, commitment and capacity to realize their wishes. The caregivers in this study argue that activities are valuable for self-esteem and physical health of people with long-term mental illness. The caregivers consider that it is the patient’s responsibility to initiate their needs of activities. This means that the caregivers do not use their knowledge about the importance of activities for the patient’s health.Search terms: activity, caregivers, mental illness.