My sibling’s mental illness: An interpretative phenomenological analysis of experiences of having an adult sibling with a mental illness in semi-rural South Africa

Abstract

Background: When there is a lack of resources in the community to support deinstitutionalisation, the siblings of an individual with a mental illness are the ones who are the most affected and vulnerable. Nevertheless, sibling care work is still largely unacknowledged in the mental health sector in low- and middle-income countries.Aim: This article describes and interprets the lived experiences of ‘black’ isiXhosa-speaking individuals having a sibling with a mental illness, to shed light on how mental health professionals might support and sustain the involvement of individuals in the treatment and care of their sibling.Setting: The study was conducted in a semi-rural town in the Eastern Cape of South Africa.Methods: The study employed a qualitative research design using interpretative phenomenological analysis as the research method. Semi-structured interviews were conducted and analysed.Results: The findings present interview extracts which give voice to participants’ experiences of financial burden, social burden and stigma, and of engaging with psychiatric treatment while providing care for their mentally ill sibling. Findings also highlight the positive aspects of caring for a sibling with a mental illness.Conclusion: This study specifically highlights the gendered nature of care work and siblings’ increased understanding of mental illness by virtue of their relationship with their brother or sister, thereby possibly pointing to sibling relationships as valuable relational resources for challenging stigma. The study findings suggest that calls for greater cooperation between healing belief systems should include dialogue with western religious belief systems alongside traditional healing belief systems.

The psychosocial stressors of siblings of people with experiences of psychosis (SOPEP): A systematic narrative review across cultures

“…It was like he is doing it for fun. (Young & Flannigan, 2021) Dependent on SOPEP's personal and social identity, their experiences of having an 'ill' sibling may vary. This may have an impact for SOPEP during adolescence and early adulthood on the sibling relationship (Graves et al, 2021), relationships with their parents (e.g., feeling abandoned) and their psychosocial functioning.…”

“…When my parents die … I think (caregiving) would fall to me. (Dodge & Smith, 2019) 3.3.4 | Personality traits SOPEP expressed compassion, empathy and patience towards their sibling and wanting to provide a calming presence when socialising together (Al-Sawafi et al, 2021;Al Sawafi et al, 2022;Amaresha et al, 2019;Bishop & Greeff, 2015;Day & Petalas, 2020;Graves et al, 2020;Liu & Zhang, 2019;Park & Lee, 2017;Young & Flannigan, 2021). SOPEP desired patience when communicating with their siblings, mostly when they felt exhausted or frustrated by the sibling's behaviours (Amaresha et al, 2015;Kovacs et al, 2019).…”

“…Most studies described the care demands for SOPEP. Some SOPEP described caregiving as stressful, burdensome and associated negative impacts (Amaresha et al, 2015(Amaresha et al, , 2019Kovacs et al, 2019;Liegghio, 2017;Park & Lee, 2017;Paul & Nadkarni, 2017;Seeman, 2013;Young & Flannigan, 2021). SOPEP discuss the 'demands for money' (Seeman, 2013) and financial burden from hospitalisation fees and medications (Amaresha et al, 2015;Park & Lee, 2017;Yang et al, 2017), whilst others had paid for traditional healers (Al-Sawafi et al, 2021;Amaresha et al, 2019).…”

“…… It's a burden. (Young & Flannigan, 2021) SOPEP may have additional responsibilities (i.e., families and young children) that create challenges in socialising and involvement in their sibling's care (Amaresha et al, 2015;Yang et al, 2017).…”

Experiences of family members caring for a sibling with mental illness in Giyani, Limpopo

“…This view is supported by Park and Lee ( 2017 :97), who found that limited information is available about sibling caregivers because existing studies focus on other family relationships, such as those with parents, spouses and children. Besides the study by Young and Flanagan ( 2021 ), there is a paucity of literature regarding the experiences of siblings caring for their sisters or brothers in South Africa. To fill this knowledge gap, the purpose of this study was to describe family members’ experiences caring for a sibling with mental illness in Giyani.…”