How do family members perceive re-integration of male state patients into their families in South Africa? A qualitative analysis

Abstract

Background: State patients are admitted to a psychiatric hospital after being declared as such by the magistrate courts as a result of not found fit to stand trial for the offence they had committed. After successful rehabilitation of state patients at the psychiatric hospital, they need to be re-integrated into their families. Family members’ perceptions regarding re-integration of male state patients are not largely explored in the scientific body of knowledge.Aim: The aim of the study was to determine the perceptions of family members regarding reintegration of male state patients into their families.Setting: This study was conducted in Vhembe District of Limpopo province, South Africa.Method: A qualitative approach using explorative, descriptive and contextual designs was adopted. In-depth interviews were conducted with 10 family members who were purposefully sampled, and data were thematically analysed using Tech Open Coding method.Results: Three themes emerged, namely, family members understand re-integration; family members’ expectations from a mental healthcare user; and threat to re-integration as perceived by family members.Conclusion: Data revealed that family members have varied perceptions regarding re-integration. These perceptions were based on the behaviour displayed or an offence committed by the mental healthcare user before admission and how participants experienced it. The study recommends that an investigation is to be conducted on the kind of support family members need regarding re-integration of state patients into their families.

Experiences of family caregivers in forensic mental health care—A qualitative evidence synthesis

“…The majority of caregivers and families had been exposed to mental and physical violence by the service user over many years (Chemerynska et al, 2020; Finlay‐Carruthers et al, 2018; Lavhelani et al, 2020; Livingston et al, 2016; Mothwa et al, 2020; Paradis‐Gagné, Holmes, & Jacob, 2020; Paradis‐Gagné, Holmes, & Perron, 2020). In many cases, the criminal offence(s) had been directly targeted at the family (Lavhelani et al, 2020; Livingston et al, 2016; Paradis‐Gagné, Holmes, & Jacob, 2020; Paradis‐Gagné, Holmes, & Perron, 2020; Tingleff et al, 2019). The following example illustrated violence against a mother: “I am afraid of his bad conduct, that if he comes back, he will raise trouble.…”

“…The following example illustrated violence against a mother: “I am afraid of his bad conduct, that if he comes back, he will raise trouble. He also hit me with his fist and two of my teeth fell out” (Lavhelani et al, 2020 p. 5). Violence was also characterized by service users' episodes of strangulation attempts on siblings, or threats to burn the house down with family members inside.…”

“…In Finlay‐Carruthers et al (2018), caregivers described how struggling to get support from the HCPs led to caregiver acceptance of ongoing responsibilities for the service user. This current theme connected to the theme “violence against family.” For example, if the service user refused to take medication or felt pressured to do so, while at home on a visit, it could become very burdensome for the caregiver and the rest of the family, if the service user reacted in a violent manner, as a result of not taking their prescribed antipsychotics or sedative medication (Lavhelani et al, 2020; Mothwa et al, 2020; Paradis‐Gagné, Holmes, & Jacob, 2020; Paradis‐Gagné, Holmes, & Perron, 2020). Thus, caregivers seemed to be faced with a dilemma: not only did they have the responsibility to provide care, they were also a controller and, at the same time, had to consider the care and safety of themselves and other family members (Paradis‐Gagné, Holmes, & Perron, 2020).…”

“…Other indications of victimization included situations where a caregiver did not believe there had been a crime, or believed that the patient had been falsely accused (Mothwa et al, 2020). In the study by Askola et al (2017), some caregivers directly described the service user as a victim or that they could not be held accountable for the offence, because, for example, it was committed in connection with a psychotic episode or other states of mental illness (Askola et al, 2017; Lavhelani et al, 2020). In Tingleff et al (2019), caregivers considered that the service user had been unfairly treated or was a victim, due to lack of professional care.…”

Family Perspectives Related to Caring for Mental Health Care Users: A Case Study in the Long-Term Mental Health Institutions of Limpopo Province, South Africa

“…Another challenge to family involvement in MHCUs care as encountered in this study is substance use by the patients. Substance use by MHCUs has been implicated in the disruption of social support from the family and community as well as relapse, resulting in MHCUs’ readmission to the hospital even before the completion of the scheduled dates for the LOA [ 21 ]. Family members are reluctant to request LOAs for MHCUs who abuse substances during this period, because substance abuse makes it more difficult for families to cope with caring for MHCUs at home [ 22 ].…”