Perceptions of psychosocial disability amongst psychiatric service users and caregivers in South Africa

Abstract

BackgroundIn many parts of South Africa there is little support for people with psychosocial disability caused by schizophrenia, beyond provision of psychotropic medications. Appropriate community-based psychosocial rehabilitation interventions are a crucial element of mental health service development.ObjectivesThis study aimed to use an explanatory model of illness framework to document experiences of illness, disability and recovery amongst service users with schizophrenia and their caregivers in a poorly resourced area in the North West Province. Data were used to provide recommendations for a contextually appropriate non-specialist facilitated group psychosocial rehabilitation intervention.MethodEighteen in-depth individual interviews were conducted: nine with schizophrenia service users and nine with caregivers. Interviews were conducted by two trained field researchers; both clinical psychologists fluent in the first language of participants. All interviews were recorded, translated and transcribed. Data were thematically analysed using NVivo 9.ResultsParticipants linked the illness to witchcraft, poverty and stress. Family conflict was recognised in the course of the illness, causing stress and challenges for emotional well-being. Knowledge of diagnosis and biomedical treatment was minimal. Key factors recognised by service users as promoting recovery were the ability to work, and the support of traditional healers and religious structures.ConclusionBased on the findings of this study, a group psychosocial rehabilitation intervention emerged as a recommendation, with the incorporation of psycho-education, adherence support, coping skills, and opportunities for income generation and productive activity. The importance of also enlisting the support of religious leaders and traditional healers in supporting recovery is emphasised.

From darkness to light: Barriers and facilitators to mental health recovery in the South African context

“…These results confirm the results in previous studies that positive family and service provider relationships play a facilitative role in the South African context (Brooke-Sumner et al, 2014).…”

Experiences of the COVID-19 pandemic amongst individuals with severe mental health conditions and caregivers in South Africa: a qualitative study

“…In relation to managing anxiety, caregivers in particular described the role of religion in coping with feelings of lack of control and assisting them in nding acceptance of the uncertainty of their circumstances. Religious faith can be a key coping strategy for people with mental health conditions and families in South Africa [74] and some other LMIC [75,76]. Its function of being a route to nd meaning and hope, as well as a source of support and social connection, can be a key aspect of recovery [11,77,78].…”

Bridging the gap: investigating challenges and way forward for intersectoral provision of psychosocial rehabilitation in South Africa

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