Perceived feasibility, acceptability and impact of the family involvement intervention for severe mental illness: a qualitative study in Masaka - Uganda.

Journal: International journal of mental health systems

Volume: 18

Issue: 1

Year of Publication: 

Affiliated Institutions:  Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda. turiho@mail.com. Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda. Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania. Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK. v.j.bird@qmul.ac.uk. Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK. Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

Abstract summary 

The burden of severe mental illness is high in low-resource settings like Uganda. But most affected people are not treated due to inadequacy of sectoral funding and trained mental health professionals. Medication has hitherto been the main method of treatment for severe mental illness worldwide. However, there is a growing realization that the use of community-based resource-oriented interventions like the family involvement are more effective and suitable for under-resourced settings. But there is a paucity of information about its applicability in Uganda.We based the intervention at the mental health unit of Masaka Regional Referral Hospital, involving 30 patients with SMI, 60 family members and friends, and 6 mental health clinicians. It was delivered through regular monthly meetings of 5 patients, 10 caretakers, and 2 clinicians each, for six months. A purposive sample of 15 patients, 15 caretakers, and 6 clinicians participated in this qualitative evaluation study after 6 months. Data was collected using in-depth interviews. Atlas.Ti (version 7.0.82) computer software was used in data analysis. Both priori and grounded codes were used to code data.We evaluated perceived feasibility, acceptability and impact of the intervention in the Ugandan context. The findings were largely positive. Feasibility was mainly driven by: the training of group facilitators, field support and supervision, prior relationship between participants, and scheduling and timing of meetings. Acceptability was supported by: anticipation of knowledge about mental illness, process and content of meetings, safety of meeting environment, and choice of participants and venue. Impact was majorly in domains of: knowledge about mental illness, psychosocial aspects of mental illness, networking and bonding, and patients' quality of life. The success of the intervention would further be enhanced by its decentralization and homogenized composition of groups.The intervention promises to spur improvement in the following main aspects of mental health services: accessibility since the meeting environment is more neutral and friendlier than the clinical setup; knowledge of mental illness; recognition of the important role of the family in management of mental illness; adoption of holistic approaches to mental illness; and quality of life of patients.

Authors & Co-authors:  Turiho Andrew Kampikaho AK Musisi Seggane S Alinaitwe Racheal R Okello Elialilia S ES Bird Victoria Jane VJ Priebe Stefan S Sewankambo Nelson N

Study Outcome 

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Statistics
Citations :  Wait S, Harding E. Moving to social integration of people with severe mental illness: from policy to practice. ILC - UK: 2006.
Authors :  7
Identifiers
Doi : 23
SSN : 1752-4458
Study Population
Male,Female
Mesh Terms
Other Terms
Acceptability;Family involvement;Feasibility;Impact;Severe mental illness;Uganda
Study Design
Grounded Theory
Study Approach
Qualitative
Country of Study
Uganda
Publication Country
England